mindfulness based stress reduction interventions
TRANSCRIPT
MINDFULNESS BASED STRESS REDUCTION INTERVENTIONS
AND SECONDARY TRAUMATIC STRESS OF
SUPERVISORS IN THE WORKPLACE
A Thesis Presented to the Faculty
of
California State University, Stanislaus
In Partial Fulfillment
of the Requirements for the Degree
of Master of Social Work
By
Samantha Nicole Valladares
May 2019
CERTIFICATION OF APPROVAL
MINDFULNESS BASED STRESS REDUCTION INTERVENTIONS
AND SECONDARY TRAUMATIC STRESS OF
SUPERVISORS IN THE WORKPLACE
by
Samantha Nicole Valladares
Dr. John Garcia
Professor of Social Work
Yvonne Berenguer, MSW
Lecturer of Social Work
Date
Date
Signed Certification of Approval page
is on file with the University Library
© 2019
Samantha Nicole Valladares
ALL RIGHTS RESERVED
iv
DEDICATION
I want to dedicate this to my great grandmother, Juanita, and great aunt, Mary,
who are not able to see this accomplishment I have achieved but I know they are with
me.
I would also like dedicate this work to the many supervisors I’ve had in my
life ever since I entered in the workforce. Thank you for teaching me what it looks
like to lead, that work is easier when done as a team and that if I know I did all that I
can, to leave the rest at work. Thank you for always being available when I inevitably
always went to you for support.
I would like to show my gratitude to Dr. John Garcia, my thesis chair, who
has provided the utmost guidance and patience throughout this process and
encouraging me to take on the challenge of writing a thesis. I want to show my
appreciation to Yvonne Berenguer for letting me be apart of her work and this
exciting study. I also want to thank Dr. Kilolo Brodie for the support she provided
and reminding me that I can do this and finish it. Without the support all of you
provided me it would have been a much more difficult process, thank you..
v
ACKNOWLEDGEMENTS
To my family. My mother Jody Munoz and my grandmother Connie Chavez
for always knowing I have it within me to do anything and showing me strength and
resilience to pursue and challenge those challenges head on. I also want to thank my
brother for always believing in me and making me think about things different, which
is what social work is all about. I also want to thank Krystopher for understanding
and being a support through this process, and also making me think about things
differently and making sure I set time aside for self-care! To all the strong women in
my family: Andrea, Cynthia, Clara for always supporting me and showing me
throughout my life the importance of family.
To friends, faculty, coworkers and everyone I have met throughout my
journey who believed in me, inspired me, and cheered me on along the way. I want to
thank the many people I have worked with along the years who have encouraged me
in so many ways and have reminded me to always be the light in someone’s life and
if anything, just smile and laugh.
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TABLE OF CONTENTS
PAGE
Dedication ............................................................................................................... iv
Acknowledgements ................................................................................................. v
List of Tables .......................................................................................................... viii
Abstract ................................................................................................................... x
CHAPTER
I. Introduction ........................................................................................... 1
Statement of Problem ................................................................ 1
Statement of Purpose ................................................................ 5
Significant of the Study ............................................................ 6
II. Literature Review.................................................................................. 7
Overview ................................................................................... 7
Leadership Styles in Social Work ............................................. 8
Supervisors and Secondary Traumatic Stress ........................... 12
Mindfulness Based Stress Reduction Intervention ................... 15
Frameworks............................................................................... 17
III. Methodology ......................................................................................... 19
Overview ................................................................................... 19
Design ....................................................................................... 19
Tools for Well-Being: The Independent Variable .................... 20
Instrumentation ......................................................................... 21
Sampling Plan ........................................................................... 21
Data Collection ......................................................................... 21
Plans for Data Analysis ............................................................. 22
Protection of Human Subjects .................................................. 23
IV. Results ................................................................................................... 24
Overview of Sample ................................................................. 24
Itemized Individual Analysis: Mindfulness Awareness and
Secondary Traumatic Stress ...................................................... 25
vii
Collective and Individual Progress: Mindfulness Awareness and
Secondary Traumatic Stress ...................................................... 29
Individualize Progress .............................................................. 32
Summary ................................................................................... 36
V. Discussion ............................................................................................. 28
Overview of Major Findings ..................................................... 28
Existing Knowledge .................................................................. 40
Limitations ................................................................................ 41
Implications............................................................................... 42
References ............................................................................................................... 46
viii
LIST OF TABLES
TABLE PAGE
1. Highest Mean Scores Pre-Test: SPTSS ............................................................ 26
2. Highest Mean Scores Post-Test: SPTSS ........................................................... 27
3. Highest Mean Scores Pre-Test: MAAS ............................................................ 28
4. Highest Mean Scores Post-Test: MAAS........................................................... 29
5. Comparison of Mean Scores of the pretest and post-test scores: SPTSS ......... 30
6. Comparison of Mean Scores of the pre-test and post-test scores: MAAS ........ 31
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ABSTRACT
Research examining the effects of secondary traumatic stress among social worker
supervisors is limited, as most studies combine front line social workers with
supervisors. The purpose of this study is to explore the impacts of mindfulness-based
stress reduction techniques when practiced by supervisors in the workplace. This
study focused on supervisors and lead workers in the Employment & Training
Department of Merced County utilizing mindfulness-based techniques from the Tools
for Well-Being. This research used a pre-experimental design using a pre-test and
post-test and an individual weekly session feedback form. The study began with 11
participants. At the end of the eight weeks, four participants were present to complete
the post test. The participants showed low scores related to mindfulness awareness at
the pre-test stage. These findings appear to suggest that interventions of this nature
are needed in keeping with the needs of social work supervisors. However,
unfortunately, with only four participants completing the post-test, it is difficult to
determine the effectiveness of the intervention in increasing mindfulness and
reducing secondary traumatic stress. Nevertheless, the findings do offer insight
regarding the needs of supervisors. First, there is a clear need to understand the
obstacles that supervisors face in participating and completing interventions of this
nature. Additionally, the results did reveal that the four supervisors who completed
the intervention appeared to gain knowledge related to mindfulness and decreases in
stress. Implications for social work practice, policy and future research are discussed.
1
CHAPTER I
INTRODUCTION
Statement of Problem
‘Burnout’ is a termed first used in the 1970’s by American psychologist
Herbert Fruedenberger to describe the severe stress and high ideals of the helping
profession. Burnout happens when an individual becomes overwhelmed and is unable
to meet constant demands of their work. As the stress of meeting demands continues,
the person begins to lose interest and motivation to take on or continue in a certain
role (Wilcockson, 2011). The effects of burnout can look like symptoms of stress,
physically and emotionally. Physically, an individual may feel fatigue, headaches,
and experience a lowered immune function which increases susceptibility to illness
such as cold and flu or increased symptoms, sleep disturbances, and gastrointestinal
disorders (Maslach & Leiter, 2008). Emotionally, an individual may feel exhausted,
develop a cynical outlook in order to depersonalize and create distance between
oneself and aspects of the job (Maslach & Leiter, 2008). Burnout can lead to or be
associated with various forms of negative responses to the job such as job
dissatisfaction, low commitment to organization or job duties, poor workplace
morale, absenteeism, intention to leave the job, and turnover (Maslach & Leiter,
2008). Workers experiencing burnout reported that their job had a negative impact on
their family and that their relationships were strained and unsatisfactory (Burke &
Greenglass, 1989, 2001; Mendes, 2015).
2
Researchers have been increasingly studying the intimate connection in a
client-worker relationship, focusing on the possible negative implications left on the
social worker. The accepted idea of ‘burnout’ can be the result of secondary traumatic
stress. Secondary traumatic stress may appear similar to burnout; however, secondary
traumatic stress is the result of working directly with survivors of traumatic events
(Bourassa, 2011). Figley (1999) defined secondary traumatic stress as the result of
wanting to help others, the natural consequence of gaining the knowledge of
traumatic experience of others. Figley’s theory of secondary traumatic stress
recognized that people can be traumatized without being physically harmed or
threatened with harm. People can be traumatized by learning about a traumatic event
(Figley, 1995). Studies that have focused on exposure to traumatic events or materials
usually focused on crisis workers, such as those in the medical field and
psychotherapists (Cornille & Meyers, 1999). Bride (2007) found that social workers
are indirectly exposed to trauma and may be at risk of experiencing secondary
traumatic stress. Cornille and Meyers (1999) focused on CPS workers in their study
examining secondary traumatic stress and found CPS workers are just as likely to be
exposed to trauma in their work, whether it was reviewing cases or investigating
reports in compromising situations that may increase their risk to traumatic stressors.
Bride (2007) found that 15% of social workers met the diagnostic criteria for Post-
Traumatic Stress Disorder.
Human service agencies and helping professionals have long been concerned
about the wellbeing of social workers. Social work environments tend to be
3
characterized by high turnover resulting in higher caseloads, and an increase in the
number of deadlines to meet. Over the years various strategies have been designed to
address secondary traumatic stress, one of these strategies being mindfulness.
Mindfulness originated in Ancient Eastern tradition and has been gaining traction in
Western practices for many years. Mindfulness has a lot of definitions, however it can
be agreed that mindfulness is a way of paying attention or being aware of an
individual’s actions, thoughts, perceptions and acknowledging those feelings in a
non-judgmental and accepting way (Nagy & Bear, 2017). Heard, Hartman, and
Buschardt (2013) define mindfulness as the “relation to well-being, self-interest,
positive outlooks, calmness, and serenity; essentially physical, emotional, social, and
spiritual health” (p.26). Since the 1970s, when articles on mindfulness began to
appear in the psychological literature, Western mental health professionals and
researchers have argued that continuing to learn about mindfulness may be beneficial
to people who are suffering from a wide range of problems and disorders (Nagy &
Bear, 2017).
Bringing mindfulness into the workplace to address secondary traumatic stress
is a new concept. While some employers offer mandatory training courses around
what compassion fatigue and burnout look like, most do not offer mindfulness
techniques or skills training to manage secondary traumatic stress. In a study by
Amanullah, McNally, Zelin, Cole, Cernovsky (2017) it was acknowledged that many
hospitals do not have appropriate trainings or programs for prevention strategies. The
growing knowledge base of mindfulness shows that the mandatory trainings provided
4
are not enough to supplement the need for mindfulness trainings (Nagy & Bear,
2017). Reitz and Chaskalson (2016) found that participants who practiced daily what
they had learned in the trainings were more successful than those who did not
practice. Secondary traumatic stress is a critical managerial issue because secondary
traumatic stress negatively affects the consistency, and quality of client services as
well as the working environment (Kim & Lee, 2009). Reitz and Chaskalson (2016)
suggested that mindfulness trainings produce an improvement in three capacities that
are key for successful leadership: resilience, the capacity for collaboration, and the
ability to lead in complex conditions.
While studies have looked at mindfulness and the effects with individuals,
Dunoon and Langer (2011) recommend pulling the lens back and examining
mindfulness at a leadership level; the relationships and dynamics that come with
leadership within the role of a supervisor. Kim and Lee (2009) describe an effective
supervisor as someone who provides a frontline social worker with essential
guidelines, professional skills, and knowledge related to services as well as
communicating opinions, feelings, and decision making with mutual trust and respect.
Leaders facing challenging situations can experience a negative effect, such as being
anxious and depressed, and because they are in an influencing role, this negative
reaction directly affects employee well-being (Roche, Haar, and Luthans, 2014).
Dunoon and Langer (2011) discuss the concept of mindfulness and how it can reveal
new, different perceptions on leadership and the role of supervisors. Roche, Haar and
Luthans (2014) provide in their study initial empirical support for the value of
5
leaders’ mindfulness in combating several dysfunctional outcomes (depression,
anxiety, and negative affect) affecting today’s leaders. White and Queener (2003)
found that another supervisor characteristic, supervisor attachment style had an
impact on both the supervisors and supervisee ratings on working alliance. Daniel,
Borders and Willse (2014) found that both the supervisors’ and supervisees’
mindfulness would contribute to their perceptions of the working relationship.
Traditionally, leaders are viewed as people of authority, the management, and the
decision makers, and when leadership is viewed in this lens, the contributions of
others is minimized along with their leadership qualities in the organization (Dunoon
& Langer, 2011). Dunoon and Langer recognized that bringing in the practice of
mindfulness to leadership can enhance the qualities of the leadership which adds
overall value to an organization.
Statement of Purpose
The purpose of this study is to explore the impacts of mindfulness-based stress
reduction techniques when practiced by supervisors in the workplace. The study is
guided by the following research questions: Do social work supervisors who
participate in an 8-week mindfulness-based stress reduction program curriculum
experience reductions in secondary traumatic stress and an increase in mindfulness
awareness? Is there a relationship between mindfulness awareness and secondary
traumatic stress? Based on previous research, it is assumed that social work
supervisors engaging in mindfulness-based stress reduction training, or tools, will be
6
able increase mindfulness awareness and decrease personal feelings of secondary
traumatic stress.
Significance of the Study
This study will contribute to the growing research of secondary traumatic
stress among social workers, mindfulness awareness practices among social workers,
as well as the effects of mindfulness practiced by leaders, such as those working
under their supervision and the clients served. The growing study of secondary
traumatic stress and the effects on social workers is important and significant for
social justice as it correlates with the National Alliance of Social Workers Preamble
of enhancing human well-being and the continuance of helping others meet their
needs (NASW, 2017). Mindfulness has been linked to well-being, self-interest,
positive outlooks, calmness, serenity and all aspects of health including physical,
emotional, social, and spiritual (Heard, Hartman, and Buschardt, 2013), which then
allows social workers to effectively advance social justice.
7
CHAPTER II
LITERATURE REVIEW
Overview
The purpose of this chapter is to review the current literature to establish a
context for the study by initially examining three vital themes: leadership styles in
social work, secondary traumatic stress (STS), and understanding mindfulness and
mindfulness-based stress reduction interventions. Examining leadership styles and
different theories directly related to social work practice is important to this study as
the population looked at is social work supervisors in the workplace, a child welfare
setting. Secondary traumatic stress is important to understand as it impacts not only
the direct service providers but those in positions that may not be directly exposed to
clients and their experiences, such as those in leadership positions. Understanding
mindfulness and the intervention used in this study can assist in building interventions
and coping strategies to alleviate and combat secondary traumatic stress. It is
important for those in leadership positions to understand secondary traumatic stress
and mindfulness-based stress reduction techniques.
This chapter also looks at the relevant frameworks that support this study:
ecological theory and organizational learning theory. Ecological theory focuses on the
interaction and interdependence of the organisms and their environment (Teater,
2014). The profession of social work was built upon the concept that individuals do
not operate in isolation but are influenced by the social and physical environment
8
(Teater, 2014). Taking the ecological perspective and applying it to this study
examines the interactions between supervisors and secondary traumatic stress along
with the mindfulness-based stress reduction intervention. The second theory,
organizational learning theory, was developed by Argote and Miren-Spektor (Argote,
2013). Organizational Learning Theory is the change in the organization that occurs
as the organization acquires experience (Argote & Miren-Spektor, 2011). Using the
organizational learning theory and applying it to the study assumes that as the
organization learns about secondary traumatic stress and mindfulness-based stress
reduction interventions, the organization can adapt and apply the tool to benefit the
employees and supervisors.
Leadership Styles in Social Work
Social work as a practice has evolved from volunteer work and philanthropy
to a profession. The leadership within the social work profession has a more
complicated history because often social workers practice within organizations led by
managers from a different discipline (Sullivan, 2016). Sullivan (2016) discusses the
various reasons the social work profession has struggled to evolve leadership from a
historical context. As a profession, social work is a female dominant field; however,
women were not placed in leadership positions to the field because they were not
viewed as professionals, more of a nice aid for someone else in a time of need. Since
social work is a profession largely dominated by women and open to ethnic
minorities, these social work practitioners’ sense of powerlessness, which effects a
person’s leadership, is reinforced by their general lack of status in society (Brilliant,
9
2001). According to Rein and White (1981), most social workers are not comfortable
with the idea of power, and social workers mostly exercise this on behalf of those
least able to defend themselves, their clients. Brilliant (2001) noted social workers
suffer from a sense of powerlessness based on their connection to disadvantaged
populations, and they work in agencies in which they often feel helpless to bring
about change. Rein and White (1981) suggest social workers are reluctant to
recognize the use of power and tend not to wield professional authority based on
status and position.
Another struggle for the social work profession is the differences in how
leadership is carried out in a human services profession and a standard business
operation (Sullivan, 2016). Brilliant (2001) calls this the divide, the division of social
work values from the social work profession and recommends that social workers
should build leaderships skills and knowledge of the leadership process within the
curriculum of their education and supervision. Sullivan (2016) recognizes that many
social workers are put into positions of leadership abruptly with little to no previous
experience in training. Brilliant (2001) points out that social workers increasingly find
themselves in positions to practice in environments that are inhospitable to the social
work profession or have different patterns of behavior and different value systems
(hospitals, jails, prisons, legal systems, corporate sector, etc.). Brilliant (2001)
contends that social workers must adopt a style and mode of communication that will
make practitioners more effective with different groups while maintaining the values
of social work and keep roots grounded in social work practices. Brilliant (2001)
10
maintains that if social workers can succeed in this balance, then leadership can be
achieved in seats of power.
Elpers and Westhuis (2008) describes the trend in leadership theory that
appears to be shifting from leadership by management to leadership by
empowerment, with the intent of creating workplaces of learning that foster dignity
and respect. Sullivan (2016) sums up management as the everyday activities, tasks,
and routines that are necessary for an organization to remain viable and to function
smoothly. Management is different from leadership as leadership is described and
defined frequently including words such as vision, inspiration, innovation, creativity,
and power; there is no question that leaders play a significant role in the workplace
and the direction an organization can take (Elpers & Westhuis, 2008). The social
work supervisor is expected to encompass both these roles. Social work practitioners
must be trained and educated not only to perform as clinicians but also to see their
practice in terms of its broader socioeconomic implications as well as having the
confidence and skill to become community leaders (Brilliant, 2001). A social work
supervisor is not only likely to manage case managers, other office workers, and
possibly clients of their own, but to be knowledgeable of other interprofessional
aspects such as managing funding streams which may include grant writing, possibly
directing multiple branches of an agency from different funding streams,
communicating with various colleagues from different agencies among the
community and any stakeholders (Sullivan, 2016). This multi-faceted role of a
supervisor reflects the struggle social work supervisors face in role duality.
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Sullivan (2016) discusses two leadership styles: transformational leadership
and person-centered leadership. Transformational Leadership recognizes that staff
behavior is not driven merely by standard rewards and punishment but is motivated
by stimulating opportunities including working together for a common good. There is
less of an emphasis on formal authority and control and more on collective action and
commitment to the values and vision of the organization (Sullivan, 2016). Tafvelin
(2014) recognizes that transformational leadership is known to be the leaderships in
times of change, as often social work settings are constantly evolving as macro
practice policies change. Person-centered leadership is aligned with a strengths-based
and recovery-focused practice, putting consumers first and frontline workers right
behind; and the leader’s focus is the conditions, processes and interventions that offer
clients maximum benefits (Sullivan, 2016). Sullivan (2016) advocates the person-
centered leadership approaches is consistent with the fundamental values of the social
work profession and reflects movements in the greater social environment toward
client empowerment.
Tafvelin (2014) acknowledged that leadership styles in social work setting
were scarce and there was a need for more knowledge around the effects of leadership
in social work. Tavfelin (2014) found a direct and positive effect on transformational
leadership in social work, both on the employee role clarity and commitment. These
findings demonstrate (in a practice setting) the benefits of transformational leadership
in social work: keeping employees committed and clear of their assignments. The
person-centered leadership style, also known as the consumer-centered social work
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practice, grew from several social movements from the 1960’s and 1970’s: the civil
rights movement and legislation, deinstitutionalization of the mentally ill population
and the independent living movement of physically disabled people (Tower, 1994)
There is limited current research and studies that could be found that focused on
person centered leadership and the effects this type of leadership has on relationship
with employees or clients at this time (Sullivan, 2016).
There are themes from each style of leadership that can be pulled to be a flexible
effective leader in a social work setting. In person-centered leadership, the consumer
of services being the focus of treatment is what social work aims to be.
Transformational leadership focuses on the relationship between staff and leaders
advocating that the organization as a whole would be successful when all employees
work to maximize potential (Sullivan, 2016).
Supervisors and Secondary Traumatic Stress
It is important to note that research examining the effects of secondary
traumatic stress among social worker supervisors is limited. McCrae, Scannapieco,
and Obermann (2015) recognized the need for supervisor specific studies, as often
supervisors are grouped in with caseworkers when looking at job satisfaction,
retention, and secondary traumatic stress. McCrae et al. (2015) found that 15-20% of
the child welfare workforce is comprised of supervisors, and the majority of those
supervisors are women, ranging betweenF
D the ages of 30-50. Between 40-50% of supervisors have a social work
degree, with about one-fifth to one-third having a Master of Social Work degree.
13
Supervisors have multiple roles within their agency. From an organizational
perspective, supervisors represent the agencies’ needs but also attend to the needs of
their employees (Weiss, 2012). McCrae et al. (2015) found that child welfare
supervisors manage child welfare workers and serve as intermediaries to upper-level
management, such as program administrators and agency directors. Some child
welfare supervisors also hold caseloads and provide case-specific consultation to
workers regarding services for families and children as well as risk and safety
assessments (McCrae, 2015). Weiss (2012) found that supervision with supervisors
was the consistent factor in maintaining caseworkers, as supervisors have a
significant role in promoting service delivery and integrity of the case workers in the
agency.
A casework supervisor has three distinct functions: administrative,
educational, and supportive and these roles tend to overlap and get in the way of each
other (Weiss, 2012). This is important to recognize because when roles get in the way
of each other, role conflict and role ambiguity have been statistically shown to
correlate with burnout (Acker, 2003). In view of the supervisor’s multifaceted areas
of responsibility, the supervisor could be under not only organizational stress, but
secondary traumatic stress as well (Weiss, 2012). McCrae et al. (2015) also identified
the multiple roles of a supervisor and exposure to higher levels of stress, including
secondary traumatic stress to impact job retention and satisfaction. One study found
that 48.7% of managers and supervisors in child welfare services fell in the high or
severe range of post traumatic symptoms on the Impact of Event Scale (Regehr et al.,
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2002). Weiss describes the impact and connection of traumatic stress upon
supervisors. Caseworkers who work with traumatized clients indirectly become
traumatized themselves; these traumatized caseworkers then interact closely with
their supervisors which, from the interaction, leads the supervisor to becoming
indirectly traumatized (Weiss, 2012).
Using a bivariate and multivariate analysis, McCrae et al. (2015) showed that
supervisors who receive more frequent supervision reported lower levels of job-
related stress and time pressure and more positives perceptions of organizational
leadership. These supervisors also reported to provide more supervision to
caseworkers. It was found that greater time pressures predicted higher intent to leave,
indicating there is an important balance of workload and resources in efforts to
maintain quality supervisors (McCrae et al., 2015).
In Weiss’ (2012) study, the aim was to define and explore the connection
between secondary traumatic stress, burnout, compassion fatigue and compassion
satisfaction among casework supervisors. The results of Weiss’ (2012) study found a
link between casework supervisors and compassion fatigue. This study expanded the
scope of trauma research by comparing and contrasting caseworks’ and supervisors’
reports of traumatic experiences. Among secondary traumatic stress and burnout,
findings indicated that caseworkers reported greater levels of each than did
supervisors. One reason these levels would be greater among caseworkers rather than
supervisors is that caseworkers generally have larger caseload than supervisors,
indicating greater exposure to trauma. Overall the results from Weiss’ data analysis
15
indicated both caseworkers and supervisors experience secondary traumatic stress and
compassion fatigue and would benefit from therapeutic services.
Mindfulness Based Stress Reduction Intervention
Secondary traumatic stress, vicarious trauma, compassion fatigue and burnout
are all terms that reflect a degree of stress felt by the individual who may have been
exposed to another person’s trauma. Organizations cannot assume that employees
have automatically developed effective coping skills because of their formal
education or qualification for employment by the organization (Weiss, 2012). Interest
in mindfulness practices has increased over the past 30 years with increasing
scientific research topics and research centers developing to see the effects of
mindfulness in different aspects of health (Dhiman, 2009). Because of the emerging
research in the area of mindfulness, there can be a lack of consensus of a working
definition as to what mindfulness is and the interventions implemented (Ludwig and
Kabat-Zinn, 2008). For the purpose of this research, the focus of the studies that will
be discussed will be on mindfulness-based stress reduction intervention because of its
clinical effectiveness and fidelity.
Garland (2013) describes mindfulness as the present-oriented, nonjudgmental
awareness of cognitions, emotions, sensations, and perceptions without fixation on
thoughts of past or future. Mindfulness based stress reduction (MBSR) is a technique
derived from Buddhist meditative practices, adapted to secular practices and
originally developed in the early 1980’s at the University of Massachusett’s by Jon
Kabat-Zinn to reduce stress and manage pain (Dhiman, 2009). MBSR was originally
16
offered as an 8-week course, with participants meeting for two and a half hours for
instruction on mindfulness and various coping strategies. Participants were
encouraged to practice these skills outside the group meeting for about 45 minutes per
day, six days per week (Dhiman, 2009). Mindfulness based stress reduction
techniques can be implemented to assist individuals in combating degrees of stress
felt by the individual.
In many fast-paced work environments, MBSR has been adapted for diverse
groups and environments such as corporate clients, attorneys, judges, clergy and
professional athletes. Many business leaders have acknowledged the benefits of
meditative practices that not only benefit their professional life but trickle into their
personal lives as well (Dhiman, 2009).
Roche, Haar and Luthans (2014) tested the direct effect of participants level of
mindfulness and the intervening effect of their psychological capital (hope, efficacy,
resilience, and optimism) may have on their mental well-being. The four samples of
participants were: 1) junior managers 2) middle managers 3) senior managers 4)
entrepreneurs. Overall the study found that mindfulness interventions promoted the
leader’s well-being.
Hülsheger, Alberts, Feinholdt, Lang, and Kozlowski (2013) study looked at
the idea that MBSR reduced emotional exhaustion and improved job satisfaction.
Two studies were completed. Study one looked at daily practices of participants
practicing MBSR, with the participants journaling once right after work and once
right before bed. Participants were recruited from various interactive service jobs and
17
organizations such as hospitals, schools, public office and nursing homes. Study one
showed daily mindfulness indicated a direct relationship with emotional exhaustion
and job satisfaction. Study two was an experimental field study with a control group
and a mindfulness intervention group which received MBSR interventions.
Participants were recruited from hospitals, schools and medical practices. Both
groups completed a survey prior before receiving a diary booklet to fill for the ten
work-day period. The participants were to complete entries after work. The results of
the second study found that those receiving the MBSR interventions had higher levels
of daily mindfulness than those participants in the control group.
Mindfulness and MBSR interventions can be essential in leadership as well.
Much of a leader’s work consists of navigating the unknown, understanding people
and the environment and MBSR techniques helps with this because when a person is
mindful, a person is more aware and in control of themselves and the situations
(Dhiman, 2009). Crowder and Sears (2017) discussed how prior studies have shown
stress management training and skills development can produce measurable outcomes
in managing different levels of burnout and application of coping skills. However,
although levels of stress were being able to be managed, there was not a reduction in
emotional exhaustion, a key feature of burnout (Crowder & Sears; 2017).
Frameworks
This section discusses the theoretical frameworks that ground this study,
organizational learning theory and ecological theory. Argote (2013) describes the
organizational learning framework as “organizational experience is theorized to
18
interact with the organizational context to create knowledge” (p. 31). This means
organizational learning is a change in the organization’s knowledge that occurs as a
function of experience. There is an ongoing cycle in an organization where task
performance is converted into knowledge impacting the organizational learning
process. The knowledge then flows out of the organization and back into the
environment. This ability to learn and adapt is key in performance and long-term
success (Argote & Spektor, 2011).
In social work, from the beginning of the profession there was a concern for character
and circumstance for people and the environment as well as a concern for the
interrelations and the whole entity which encompasses them (Siporin, 1980). In
ecological theory, adapting the biological construct of ecology to include the social
identity of human beings brings with it the potential to understand our relationships to
one another as well as our place in nature (Ungar, 2002). The influence and
connection between the different parts of the environment is not static, instead it
evolves over time taking into consideration the historical and cultural context and
influences (Teater, 2014). Thinking about the world ecologically allows people to
look critically at human communities and the diversity, complexity and symbiosis
associated with them (Ungar, 2002).
19
CHAPTER III
METHODOLOGY
Overview
The use of mindfulness is an emerging technique to reduce various
effects of burnout and stress. The purpose of this experimental study is to examine the
impacts of mindfulness-based techniques when practiced by supervisors in the
workplace. This study will focus on supervisors and lead workers in the Employment
& Training Department of Merced County utilizing mindfulness-based techniques
from the Tools for Well-Being. This study examines the data gathered from a
mindfulness-based training workshop with supervisors of Merced County’s
Employment & Training Department.
The study is guided by the following research questions: Do social work
supervisors who participate in an 8-week mindfulness-based stress reduction
curriculum experience reductions in secondary traumatic stress and increase in
mindfulness awareness? Is there a relationship between mindfulness and secondary
traumatic stress? Based on previous research, it is assumed that social work
supervisors engaging in mindfulness-based practices, or tools, will be able to increase
mindfulness awareness and decrease personal feelings of secondary traumatic stress.
Design
This research will be using a pre-experimental design using a pre-test and
post-test and an individual weekly session feedback form. The two dependent
20
variables in this study are secondary traumatic stress and mindfulness. The pre-test
measures the dependent variable on a scale before the introduction of the independent
variable. After the 8 weeks of the workshop are completed, a post-test will be
administered again to test the dependent variables of secondary traumatic stress and
mindfulness to determine if the independent variable had any effect on the dependent
variables.
In addition, after each workshop, participants will complete a weekly
feedback survey that provides information on the participants’ view of the class
session.
Tools for Well-Being: The Independent Variable
The intervention of this study will consist of workshop sessions, each building
upon the previous session spanning over eight weeks. The workshops are called
“Tools for Well Being,” a new curriculum based on the literature on mindfulness,
adult resilience, stress reduction, compassion and positive psychology. Each session
builds on the previous session while introducing a new concept to lead into the next
session. The workshops will be ninety-minutes long and consist of open discussion,
various mindfulness activities, and reflections, check-ins and activities to practice
during the week. There will be optional homework, which involves the participants
practicing the skills learned and bringing back their experiences to share with the
workshop.
The first session provides an introduction to mindfulness, definitions of stress
and various exercises for breathing and mindfulness. Session two continues with
21
mindfulness and introduces gratitude and compassion. Week three builds on the
theme of gratitude and compassion and discusses these concepts in application to self.
Session four expands mindfulness in application for emotional triggers and the
impacts of those triggers on relationships. Session five introduces art as a form of
stress relief. The sixth session moves from art to writing as additional form of stress
relief. Week seven explores mindful interactions, discussing the effects of unmindful
interactions as a source of stress. Week eight explores positive psychology and its
relationship to stress reduction.
Instrumentation
Sampling Plan
The sampling plan in this study is a non-probability convenient sampling
approach. The researchers have developed a partnership with Merced County Human
Services Agency with previous research studies. The participants will be Merced
County’s Employment & Training Department supervisors and lead workers.
Participation in the workshop is voluntary. Though the workshops build on the
previous week’s workshop, if a participant misses a week, the participant is able to
resume the following week. An estimate of 8-10 participants completed the
workshops.
Data Collection
This study will have a pre-test and post-test. The pre-test will be using the
Mindfulness Awareness Attention Scale (MAAS) and the Screen for Posttraumatic
Stress Symptoms (SPTSS) for participants to complete in order to establish a
22
baseline. Each participant created a unique identifier to remain anonymous by
combining the first two letter of the name and the day and months they were born.
Once the pre-test is completed, the researcher will collect the data and place it in an
envelope, then seal the envelope and place the sealed envelope in a secured file
cabinet accessible to only the facilitator. Following the eight week workshop, a post-
test will be given. The same procedure will be followed for the post-test until the data
is ready to be compared with the pre-test scores.
During the eight week workshop, data will be collected from the evaluation
form following each workshop session. Participants are given 15 minutes after each
workshop to complete the scale. Once the scales are completed, they will be collected
by the facilitator who will then place the scales in the manila envelope and place the
envelope in a secured cabinet. The same procedure will be followed for the collection
of the informed consent as well as the remainder of the 8 week workshops. The
surveys will remain secured until the MSW student conducting the research study is
ready to analyze and interpret the data.
Plans for Data Analysis
The data will be analyzed using the Statistical Software Package for Social
Sciences (SPSS). The instrumentation of all scales will be coded, and scores will be
computed based on the instructions for the instrumentation. The plan for data
analyses will be univariate and bivariate analysis. The use of the univariate analysis
will look at the frequency distributions, measures of central tendencies and
dispersion. The will allow the researcher to analyze the participants views on how
23
well the topics for each workshop were delivered. Because the study involves two
dependent variables, a paired sample T-test can be used as well to determine the
changes between both variables, mindfulness and secondary traumatic stress.
Protection of Human Subjects
The researcher will review the informed consent procedures and inform
participants about the purpose of the study and the benefits of accomplishing the
study. After the researcher explains the study to the participants, the participants will
be given the option to accept or deny participation status of the study. The researcher
cannot anticipate any potential harm that may come to the participants as a result of
their participation in the study.
The names of the participants will not be included in the survey. The data
collected will be kept confidential, in a secure room, in a locked file cabinet
accessible to only the researcher. The data will be kept confidential at all times, and
even when presenting the study, the data will not be able to be linked back to the
participants. This study will be reviewed and approved by the Institutional Review
Board (IRB) to ensure protection and the rights of the participants of this study.
24
CHAPTER IV
RESULTS
This chapter looks at the data generated from the supervisors and the scales
looking at secondary traumatic stress and mindfulness awareness. Data were gathered
from the pre-test and post-test Mindfulness Attention Awareness Scale (MAAS) and
the Screen for Posttraumatic Stress Symptoms (SPTSS). The Mindfulness Attention
Awareness Scale is a 15-item scale designed to assess the traits of mindfulness
including mindful engagement and emotional awareness. The Screen for
Posttraumatic Stress Symptoms was designed in 2007 as a 17-item screening tool to
identify persons who may meet criteria for the diagnosis of Post Traumatic Stress
Disorder (PTSD). The Screen for Posttraumatic Stress Symptoms was designed to
closely match the DSM-IV criteria for PTSD: reexperiencing symptoms, avoidance
and emotional numbing symptoms and hyperarousal. The study was guided by the
research questions: Do social work supervisors who participate in an 8-week
mindfulness-based stress reduction curriculum experience reductions in secondary
traumatic stress and increase in mindfulness awareness? Is there a relationship
between mindfulness and secondary traumatic stress?
Overview of Sample
The sample began with 11 participants. Of the 11 participants, 10 were female
and one was male. The age ranged from 35-57, with the average age being 51.
Participants self-identified their ethnic backgrounds as: Hispanic (37%), Caucasian
25
(45%), Native American (9%), and African American (9%). Education ranged from
high school graduate (18%), some college (55%), Associates of Arts (9%), Bachelors
of Arts (9%), and Doctorate (9%). Participant job titles were Family Services
Supervisor (64%), Program Manager (9%), and Employment and Training Lead
(27%).
Itemized Individual Analysis: Mindfulness and Secondary Traumatic Stress
The study began with 11 participants, at the end of the eight weeks, four
participants were present to complete the post test. Two participants completed the
pre-test and first session but did not attend any following sessions. There were six
evaluations that were completed over the span of eight weeks, but the researcher was
unable to use these as there was no participant identification label on the evaluations.
The average classes attended by the nine participants were five out of the eight
sessions. As there were not enough participants that completed the post test, the
original plans to analyze the data using a bivariate and paired sample T-test was
unable to be completed. It was not possible to determine if the independent variable
reduced secondary traumatic stress and/or increased mindfulness awareness due to the
low participation in the post-test. It also was not possible to be determined if there is a
relationship between mindfulness awareness and secondary traumatic stress.
The itemized statements of the Mindfulness Attention Awareness Scale and
the Screen Posttraumatic Stress Symptoms that the participants all scored high on will
be looked at together in the pre-test, to see what the participants struggled the most
prior to the intervention and at post-test to see what the participants improved on the
26
most. There will be a comparison of those four participants who completed the pre-
test and post-test and independently.
Screen for Posttraumatic Stress Symptoms
The Screen for Posttraumatic Stress Symptoms pre-test had 11 participants complete
the scale. Table 1 indicates that the participants struggled with sleep quality,
motivation and concentration prior to the intervention. Prior to the intervention,
participants rated low on the statements that discussed traumatic memories such as “I
suddenly feel like I’m back in the past, in a situation that I was once in” and “I have
bad dreams about terrible things that have happened to me.”
Table 1
Highest Mean Scores Pre-Test: SPTSS
Statement
Mean Score
“I have trouble getting to sleep and
staying asleep”
5.45
“I do not feel like doing the things that
I used to like”
4.27
“I have trouble concentrating on
things or paying attention to something for a
long time”
4.00
27
Table 2 shows the statements the participants struggled with after the
intervention. It is recapped that four participants completed the post test. Looking at
Table 2, it is evident that there was an increase on the item “I have trouble
concentrating on things or paying attention for a long time.” That score increased
from a 4.00 to a 5.25. Also shown in Table 4 are the three statements that received a
mean score of 4.0. Based on Table 2, it looks like participants continued to struggle
with sleep quality, concentration, as well as emotional numbing and future
orientation.
Table 2
Highest Mean Scores Post-Test:SPTSS
Statement
Mean Score
“I have trouble concentrating on things or
paying attention to something for a long time”
5.25
“I have trouble thinking about the future and
believing that I’m going to live to an old age”
4.25
“I feel numb: I don’t feel emotions as
strongly as I used too”
4.0
“I avoid things or being in situations that
might remind me of something terrible”
4.0
“I have trouble getting to sleep and
staying asleep”
4.0
28
Mindfulness Attention Awareness Scale
Next, the statements the participants scored the highest on in the Mindfulness
Attention Awareness Scale are looked at prior to the intervention in order to establish
a baseline of the participants’ awareness to mindfulness. It is noted that 11
participants complete the pre-test. Based on the scores in Table 3, the participants
struggled with being engaged in the present moment, specifically mindful
engagement and emotional awareness. Participants did not appear to struggle with
memory recall, evidenced by scoring low on the statement “I forget a persons name
almost as soon as I’ve been told it for the first time.”
Table 3
Highest Mean Scores Pre-Test: MAAS
Statement
Mean Score
“I break or spill things because of
carelessness, not paying attentions or thinking
of something else”
4.72
“I could be experiencing some
emotion and not be conscious of it until some
time later”
4.27
“I do jobs or tasks automatically
without being aware of what I’m doing”
4.18
29
In the post-test of the Mindfulness Attention Awareness Scale, four
participants completed the post-test. Refering to Table 4, participants continued to
struggle with being aware of the present moment and struggling with mindful
engagement.
Table 4
Highest Mean Scores Post-Test:MAAS
Statement
Mean Score
“I break or spill things because of
carelessness, not paying attentions or thinking
of something else”
6.0
“I get so focused on the goal I want to achieve
that I lose touch with what I’m doing right
now to get there”
5.0
“I drive places on ‘automatic pilot’
and then wonder why I went there”
5.0
Collective and Individual Progress: Mindfulness Awareness and Secondary Post
Traumatic Stress
This section focuses on the collective and individual progress of each of the
participants that completed both the pre-test and post-test for each scale beginning
with the SPTSS. Participant 1 had an increase in score, participant 2 and participant 3
showed a decrease in score and participant 4 also showed an increase in score. These
data indicate there was an increase in stress for participant 1 and participant 4 while
30
there was a decrease in stress from participant 2 and participant 3. Refer to Table 5
for the comparison of the scores for the pre-test and post-test means for the Screen for
Posttraumatic Stress Symptoms.
Table 5
Comparison of Mean Scores of the pretest and post-test scores: SPTSS
Total Mean
Pre-Test:
SPTSS
Total Mean
Post -Test
SPTSS
Participant 1
3.47
4.0
Participant 2
6.18
3.76
Participant 3
2.59
1.18
Participant 4
2.94
3.41
In Table 6, are the comparison of the scores for the pre-test and post-test
means for the Mindfulness Attention Awareness Scale. Participant 1 showed the same
score pre-test & post-test, participant 2 and participant 3 showed an increase in score,
and participant 4 showed a decrease in score. This data shows that participant 1
showed no change in mindfulness awareness, participant 2 and participant 3 showed
an increase in mindfulness awareness and participant 4 showed a decrease in
mindfulness awareness.
31
Table 6
Comparison of Mean Scores of the pre-test and post-test scores: MAAS
Total Mean
Pre-Test:
MAAS
Total Mean
Post-Test:
MAAS
Participant 1
3.87
3.87
Participant 2
3.40
5.0
Participant 3
2.60
4.80
Participant 4
4.20
3.53
When looking at the Screen for Posttraumatic Stress Symptoms and
Mindfulness Attention Awareness Scale together for the each of the participants that
completed both the pre-test and post-test, participant 1 showed an increase in stress
but showed no change in mindfulness awareness. Participant 2 and participant 3 both
showed a decrease in stress and an increase in mindfulness awareness and participant
4 showed an increase in stress while showing a decrease in mindfulness awareness.
Due to the small number of participants that completed both the pre-test and
post-test for the Mindfulness Attention Awareness Scale and the Screen for
Posttraumatic Stress Symptoms, the statements of the tests can be examined to see
which statements the participants collectively increased or decreased on. For the
32
Screen for Posttraumatic Stress Symptoms, there was a collective decrease on two
statements: “I have trouble concentrating on things or paying attention to something
for a long time” and “I feel very irritable and lose my temper”. This indicates that the
four participants collectively increased concentration and emotional awareness. For
the Mindfulness Attention Awareness Scale there was a collective increase in three
statements: “I get so focused on the goal I want to achieve that I lose touch with what
I’m doing right now to get there”, “I do jobs or tasks automatically, without being
aware of what I'm doing” and “I snack without being aware that I’m eating.” This
indicates that the four participants were able to increase their mindfulness awareness
in the present moment.
Individual Progress
Participant 1
Participant 1 attended seven of the eight workshops. Participant 1 stated goal
at the start of the workshops was “to see what mindfulness is all about.” Participant 1
overall showed an increase in stress and no change in mindfulness awareness.
Looking at participant 1 individually there was still some improvement on certain
statements. Participant 1 improved on four statements of the Screen for Posttraumatic
Stress Symptoms scale: “I have trouble concentrating on thing or paying attention to
something for a long time”, “I feel very irritable and lose my temper”, “I get startled
or surprised very easy and ‘jump’ when I hear a sudden sound” and “I have trouble
sleeping or staying asleep.”
33
For the Mindfulness Attention Awareness Scale, the data showed Participant 1
had no change in mindfulness attention awareness. When looking at Participant 1’s
pre-test and post-test, Participant 1 showed improvement on six out of fifteen
statements. Some of the statements include: “I get so focused on the goal I want to
achieve that I lose touch with what I’m doing right now to get there”, “I do jobs or
tasks automatically, without being aware of what I’m doing” and “I find myself
listening to someone with one ear, doing something else at the same time.”
Participant 1 scored a ‘3’ on these three statements pre-test, ‘somewhat frequently’
and in post-test scored a ‘4’, ‘somewhat infrequently.’
Participant 1 provided minimal feedback to instructors on the Class
Evaluations but did state in session six as the most valuable aspect of this class
session: “writing a letter from my 99-year old self, it reminded me that troubles are
fleeting.” Participant 1 also suggested a second series of classes on Mindfulness.
Participant 2
Participant 2 attended seven of the eight workshops. Participant 2 stated the
goal of taking these classes was “to learn how to deal with day to day stress.”
Participant 2 showed a decrease in stress and an increase in mindfulness awareness.
Looking at the scores pre-test compared to the post-test, Participant 2 showed a
decrease in stress on thirteen out of the seventeen statements of the Screen for
Posttraumatic Stress Symptoms scale. Some of those statements include: “I don’t feel
like doing things that I used to like doing”, “ I have a hard time concentrating on
things or paying attention to something for a long time”, “I am very aware of my
34
surroundings and nervous about what is going on around me” and “I get very upset
when something reminds me of something bad that happened to me.”
Participant 2 showed an increase in mindfulness awareness on twelve out of
fifteen statements. Some of those statements include: “I could be experiencing some
emotion and not be conscious of it until some time later”, “I break or spill things
because of carelessness, not paying attention, or thinking of something else” and “I
tend not to notice feelings of physical tension or discomfort until they really grab my
attention.”
Participant 2 engaged in the Class Evaluations, providing information on what
Participant 2 found helpful, improvements, additional comments and suggestions.
Some additional comments include: “This session [week four] has given me some
tools to help battle the things that are having me feel like my brain is in a fire.” “I feel
so much better after each session.” “Attending these session has been a godsend.”
“This training really helps me.” “This class came along in my life when I really
needed it.” Participant 2 was consistent in the improvements that could be made:
“more time,” and “longer time.”
Participant 3
Participant 3 attended seven of the eight workshops. Participant 3 stated goal
was “to help manage my own stress levels but also to be able to pass on some
techniques and info to my own team members.” Participant 3 showed a decrease in
stress and an increase in mindfulness awareness. Looking at the scores pre-test
compared to the post-test, Participant 3 showed a decrease in stress on five out of the
35
seventeen statements of the Screen for Posttraumatic Stress Symptoms scale. Some of
those statements include: “I can’t remember much about the bad things that have
happened to me.” “I feel numb: I don’t feel emotions as strongly as I used to” and “I
have trouble getting to sleep or staying asleep.”
Participant 3 showed improvement in mindfulness awareness on all the fifteen
statements. Some of those statements include: “I forgot a person’s name almost as
soon as I’ve been told it for the first time”, “I rush through activities without being
really attentive to them” and “I find myself doing things without paying attention.”
Participant 3 engaged in the class evaluations providing information on what
Participant 3 found helpful, improvements, additional comments and suggestions.
Additional comments include: “I appreciate the safe and supportive environment the
class is.” “Great handouts.” “I almost didn’t come today because I am so
overwhelmed with my workload, but I pushed myself to come and I’m so glad I did!
Much needed!” Participant 3 suggested “more writing prompts.” Participant 3 found
many things helpful including: “the journals and handouts,” “the opportunity to
write,” and “the space to de-stress.”
Participant 4
Participant 4 attended five of the eight workshops. Participant 5 stated goal was “to
reduce stress and become a better thinker.” The data for participant 4 showed an
increase in stress and a decrease in mindfulness awareness. However, when looking at
participant 4 individually there was still some improvement on certain statements of
the Screen for Posttraumatic Stress Symptoms scale and the Mindfulness Awareness
36
Attention Scale. Participant 4 improved on five statements of the Screen for
Posttraumatic Stress Symptoms scale. Some of those statements include: “I try not to
think about things that remind me of something bad that happened to me,” “I have
bad dreams about terrible things that happen to me,” and “I get very upset when
something reminds me of something bad that happened to me.”
Participant 4 showed an increase in mindfulness awareness on six out of
fifteen statements. Some of those statements include: “I find it difficult to stay
focused on what’s happening in the present,” “It seems I am ‘running on automatic’,
without much awareness of what I’m doing” and “I snack without being aware that
I’m eating.”
Participant 4 engaged in the class evaluations providing information on what
Participant 4 found helpful, improvements, additional comments and suggestions.
Additional comments include: “Relaxing”, “I always feel more relaxed after the
class” and “This class is unlike any other.” Participant 4 found helpful: “Mindfulness
can help me to deal with different situation during the day.” “The section on the
human brain” and “expressing my feelings through writing.”
Summary
In summary, it was not possible determined if supervisors who participated in
an 8-week mindfulness-based stress reduction workshop reduced secondary traumatic
stress and increased mindfulness awareness due to the low participation in the post-
test. It also was not possible to be determined if there is a relationship between
mindfulness awareness and secondary traumatic stress. Among the four participant
37
who completed the pre-test and post-test, one participant showed an increase in stress
reduction and a decrease in mindfulness awareness and one participant showed a
slight increase in secondary traumatic stress and no change in mindfulness awareness.
Two participants did demonstrate a decrease in secondary traumatic stress with an
increase in mindfulness awareness following the 8-week mindfulness-based stress
reduction intervention.
The next chapter focuses on the major finding, implications for social work
practice and policy, limitations of the intervention, comparison to the literature and
recommendations for future research.
38
CHAPTER V
DISCUSSION
This study examined the effectiveness of an 8-week mindfulness-based stress
reduction intervention on secondary traumatic stress and mindfulness awareness that
was implemented with the supervisors and lead workers in the Employment &
Training Department of Merced County. This study was interested in understanding
the effectiveness of the intervention in decreasing secondary traumatic stress and
increasing mindfulness. The research questions that guided this study were: Do
supervisors who participated in an 8-week mindfulness-based stress reduction
workshop experience reductions in secondary traumatic stress and increases in
mindfulness awareness? And, is there a relationship between mindfulness awareness
and secondary traumatic stress? The intervention was introduced to supervisors and
lead workers at the Employment and Training Department of Merced County with the
goal of decreasing secondary traumatic stress and increasing mindfulness awareness.
Overview of Major Findings
The results of the study are tentative due to the low participation in the post-
test, and the plan to uncover the findings required modification due to the level of
participation in the post-test surveys. The study began with 11 participants
completing the pre-test and four participants completed the post-test. The scores of
the four participants that completed both pre-test and post-test were examined, and it
was found that among the four participants one participant showed an increase in
39
stress reduction and a decrease in mindfulness awareness and one participant showed
a slight increase in secondary traumatic stress and no change in mindfulness
awareness. Two participants did demonstrate a decrease in secondary traumatic stress
with an increase in mindfulness awareness following the 8-week mindfulness-based
stress reduction intervention which was what the study was looking for.
When looking at the individual scores from the pre-test for all participants,
there were high levels of stress the participants may have been unaware about prior to
participating in the mindfulness training. The participants also showed in the pre-test
low scores related to mindfulness awareness. These findings appear to suggest that
interventions of this nature are needed in keeping with the needs of social work
supervisors. Though not all participants were able to complete the post test or attend
all the workshops in the interventions, most of the participants understood it was
needed. One participant stated they wanted “coping skills.” Another participant stated
they wanted an “understanding of mindfulness.” Another participant stated their
motivation for participating in the workshops was to “decrease secondary trauma that
impacts staff and myself.” Throughout the weeks, participants that attended the
classes shared similar sentiments. One participant shared “The entire class was
valuable, the coping tools/techniques learned were useful and desired.” Another
participant shared “I love the exercises and guided meditation. This class is helping so
much. Thank you.” Another participant shared, “Totally enjoyed the classes,
appreciated what I have learned and the gifts and tools you provided for me!” These
40
statements reflect the need for this intervention and support from the agency to allow
supervisors to attend all trainings in the intervention.
Existing Knowledge
Currently there continues to be a lack of information on how mindfulness
interventions have been applied to social work supervisors in the workplace. There
has been an increase of studies focusing on the effectiveness of mindfulness-based
interventions in various diverse environments such as schools, hospitals, places of
business. This study focused on three points: mindfulness-based stress reduction
interventions, secondary traumatic stress and supervisors in social work practice.
It is important to note again when looking at the research how leadership in
the social work profession is carried out, a duality of human services and standard
business operations needs to be considered. The low number of participants in the
post-test can be a reflection on the many responsibilities a social work supervisor has.
One participant demonstrated an increase in stress and a decrease in mindfulness
awareness which is opposite of what the study was hoping to find.
The research tends to focus its study on social workers in general, with some
studies focusing on social work supervisors and traumatic stress. It is important to
understand how secondary traumatic stress affects supervisors: Caseworkers who
work with traumatized clients indirectly become traumatized themselves; these
traumatized caseworkers then interact closely with their supervisors which, from the
interaction, leads the supervisor to becoming indirectly traumatized (Weiss, 2012).
41
Understanding how secondary traumatic stress affects a social work supervisor can
impact how a participant rates their scores in the SPTSS.
The mindfulness-based stress reduction intervention in this study followed the
8 week structure similar to the mindfulness based curriculum developed by Jon
Kabat-Zinn. Other parts of the curriculum were modified such as the time. In this
study the intervention was 90 minutes as opposed to the two and a half hours in
Zinn’s study. The studies looked at in the literature review showed mindfulness
increased personal wellbeing, reduced emotional exhaustion and increased daily
mindfulness and job satisfaction. Though this study was unable to determine if an 8-
week mindfulness based stress reduction intervention reduced secondary traumatic
stress and increased mindfulness awareness in social work supervisors or if there is a
relationship between mindfulness awareness and secondary traumatic stress, two
participants did demonstrate this. Two participants demonstrated a reduction in
secondary traumatic stress and an increase in mindfulness awareness.
Limitations
There were limitations to the research. A limitation was the sample size. A
larger sample size would have been ideal to see statistical differences of the
intervention. The other limitation with the sample size was with the post-test; only 4
participants completed the post-test which was a major limitation to this study. Due
lack of participants in the post-test, statistical tests were not able to be done to
compare the pre-test with the post-test. Ideally, the number of participants to
complete a pre-test would be available to complete the post-test.
42
Another limitation may be the length of the intervention. The average amount
of classes participants attended was five. Either efforts could be made to ensure
attendance from participants over the 8-weeks or condensing the intervention to 4-5
weeks. As mentioned in existing knowledge, when looking at the research social
work supervisors have many roles and responsibilities; it is possible, as evidenced by
one participant, that the added responsibility of the 8-week intervention increased
stress felt.
Implications
Future research of secondary stress and social work supervisors in the
workplace is still an area that is needed. It is needed because as the research has
observed, social work supervisors are often experiencing a workplace environment
that sometimes go directly against the social work values and are thus experiencing
increases in secondary traumatic stress. Another implication is the multiple roles
supervisors are often faced with may get in the way of full participation in the
intervention. (Example: if a frontline staff calls out, often the supervisors is called on
to fill in for the frontline staff appointments). The research that has been done looking
at social work supervisors tells us that often social workers promoted to supervisory
roles are unprepared for the role and responsibilities of a supervisor in the field of
social work, increasing stress once in that role (Acker, 2003; McCrae, 2015; Brilliant,
2001).
The Merced County Employment and Training department requested a
mindfulness-based curriculum specifically for supervisors and lead workers after the
43
front line staff received this intervention. As the social work field evolves and so do
the diverse responsibilities of the social work supervisor, polices should be
considered, developed and reviewed on how to manage secondary traumatic stress.
Agencies must realize that managing stress is ongoing, and that one training is not
enough to manage ongoing secondary stress. Stress is complex and affects individuals
differently. In efforts to prevent turnover and low productivity, acknowledging
secondary traumatic stress (and in its different but similar forms of burnout,
compassion fatigue and vicarious trauma), agencies must make available ongoing
trainings and support full participation in the length of the trainings. As well as
offering ongoing supervision and support for their social work supervisors. Providing
support for managing secondary traumatic stress for social work supervisors is
directly aligned with the ethical standards of the National Alliance of Social Workers
Code of Ethics.
The research has a few implications for future studies with social work
supervisors such as more research with agencies that acknowledge the benefits of a
mindfulness-based curriculum, a larger sample size, consistent participation across
the workshops. Though most agencies in the social work field understand and
acknowledge mindfulness-based interventions, research has shown there are not many
agencies that provide this type of support for social workers or social work
supervisors (Nagy & Bear, 2017). The research does support the notion that providing
supervisors who work in a high demanding field (with high levels of stress and
exposure to secondary traumatic stress) with a mindfulness-based stress reduction
44
curriculum increases resilience, optimism, capacity to collaborate, effective
leadership in complex situations, overall quality of services and overall personal well-
being (Crowder & Sears; 2017). It is important to recognize that the well-being of
supervisors can affect the people they supervise and the organization as a whole.
Recognizing and promoting efforts to support supervisor well-being can reduce
burnout with the individual as well as the people they supervise which then can
prevent turnover and promote organizational stability. This can then positively impact
the children, families and people that are served.
REFERENCES
46
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