How does STS Impact Child Welfare?

“One year, as my husband and I were driving around admiring Christmas lights, I found myself making comments about whether children had been abused in any of the homes. With the look my husband gave me, I immediately knew something was going on

with me.” --Rural CPS worker

CPS professionals are at a higher risk than other helping professions for developing STS symptoms because of their daily contact with physically, sexually, and emotionally abused children and traumatic material; exposure to child deaths; and threats of violence and assaults against themselves. (Choi, 2011)

• 72% of CPS workers (n=183) reported having worked with a

child who witnessed an actual death (Cornille & Meyers, 1999)

• 99% of workers reported having worked with a child who had been sexually abused (Cornille & Meyers, 1999)

Individual and Organizational Impact of STS

(Bride, 2007; Choi, 2011, Zlotnik et al., 2005)

What is the Prevalence of STS in Child Welfare?

“I’m a man but I wake up crying at night; I can still smell that baby’s burnt buttocks. It’s terrible.” (Jankoski, 2010, p.115)

• 37% of CPS respondents (n=183) reported clinical levels of emotional distress associated with STS (Cornille & Meyers, 1999)

• 34% of responding CPS professionals (n = 187) met the criteria for work-related PTSD (Bride, Jones & MacMaster, 2007)

• 92% of CPS professionals reported experiencing at least one STS symptom (Bride, Jones & MacMaster, 2007)

• 59% of CPS professionals reported experiencing more than one symptom of STS (Bride, Jones & MacMaster, 2007)

Prevalence of Secondary Traumatic Stress

What is Secondary Traumatic Stress?

Secondary Traumatic Stress (STS) is characterized by symptoms of intrusion, avoidance, and arousal resulting from empathic engagement with traumatized clients as well as exposure to traumatic stories and events. It is considered an occupational hazard for social service providers (Figley, 1999; Jenkins & Baird, 2002).

What are the Symptoms of STS?

Symptoms parallel those of Post-Traumatic Stress Disorder (PTSD).

(Bride, 2007)

Understanding Secondary Traumatic Stress in Child Welfare Patricia Shannon, Ph.D.; Anna Carpenter, MSW Candidate; Tonya Cook, MSW Candidate

School of Social Work

Defining Secondary Traumatic Stress

What are the Risk Factors for STS?

Individual as well as environmental factors contribute to the high prevalence of STS in child welfare work.

(Anderson, 2000; Bride, Jones & MacMaster, 2008; Dane, 2000; Cornille & Meyers, 1999 ; Dill, 2008; Horowitz, 2008)

What are Strategies for Reducing STS?

A number of strategies can be implemented at the individual and organizational levels to reduce the high prevalence of STS in child welfare work. Personal Strategies

• Pursuing further education

• Increasing leisure time and self-care activities

• Emotion-focused (vs. problem-focused) coping strategies

• Increasing personal and professional social support

• Psychoeducation about stress management

• Seeking therapy to identify numbing, flooding, and hypervigilance effects , resultant cognitive distortions, and maintaining adaptive workplace and personal functioning

• Reducing unnecessary exposure to traumatic material

Organizational Strategies

• Offering continuing education that addresses the emotional impact of the work and strategies for managing stress

• Offering peer support programs

• Job rotation to limit high stress situations and facilitates new skill development

• Supporting self-care for supervisors and staff members

• Implementing Interventions that increase the safety of workers

(Anderson, 2000; Bride, Jones & MacMaster, 2008; Dane, 2000; Cornille & Meyers, 1999 ; Dill, 2008; Horowitz, 2008)

Risk Factors and Strategies for Reducing STS

Anderson, D.G. (2000). Coping strategies and burnout among veteran child protection workers. Child Abuse & Neglect, 24(6), 839-848. Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63-70. Bride, B.E., Jones, J.L., MacMaster, S.A., and Shatila, S. (2003). The Tennessee Child Protective Services Supervisors Development Project: Evaluating Process, Outcome, and the Role of Secondary Traumatic Stress and Burnout. The International Journal of Continuing Work Education, 6(2), 79-84. Choi, G. Y. (2011). Organizational impacts on the secondary traumatic stress of social workers assisting family violence or sexual assault survivors. Administration in Social Work, 35(3), 225-242. Cornille, T. A., & Meyers, T. W. (1999). Secondary traumatic stress among child protective service workers. Traumatology, 5(1), 15-31. Dane, B. (2000). Child welfare workers: An innovative approach for interacting with secondary trauma. Journal of Social Work Education, 36(1), 27-38. Dill, K. (2007). Impact of stressors on front-line child welfare supervisors. The Clinical Supervisor, 26(1-2), 177-193. Horwitz, M. (2006) Work-related traumatic effects in child protection social workers. Journal of Social Service Research, 32(3) 1-18. Jankoski, J. (2010). Is vicarious trauma the culprit? A study of child welfare professionals. Child Welfare, 89(6), 105-120.

References

Research shows that STS has many harmful effects for workers, organizations, and clients. Despite these hazards, some workers are able to successfully cope and work for many years in the field of child protection. Much more research is needed to be able to understand:

• Relative contribution of risk factors

• Strategies that mediate stress at individual and organizational levels in child welfare

Recommendations for Further Research

Impact of STS on CPS Professionals

Organizational Impacts of STS

• Short-and long-term emotional and physical disorders

• Strains on interpersonal relationships

• Substance abuse

• Burnout

• Oversensitivity or decreased sensitivity to violence

• Diminished self-confidence in using clinical skills

• Decreased energy, cynicism, despair or hopelessness

• High staff turn-over and interruption of services to clients

• Costs of recruiting and training new staff

• Diminished service quality

Intrusion Avoidance Arousal • Intrusive

thoughts about clients

• Disturbing dreams about clients

• Sense of reliving clients’ trauma

• Psychological distress or physiological reactivity in response to reminders of traumatic events or stories

• Avoidance of clients

• Avoidance of people, places, things

• Inability to recall client information

• Diminished activity level

• Detachment from others

• Emotional numbing

• Sense of foreshortened future

• Difficulty sleeping

• Irritability

• Difficulty Concentrating

• Feeling constantly watchful or on guard

• Easily startled

Personal Factors Organizational Factors

• Cumulative life stressors

• Length of time in profession

• Personal history of trauma

• Cognitive and avoidant coping strategies

• Inexperience/lack of educational background in social work

• Large caseloads

• Working over 40 hours/week

• Administrative pressures to close protection investigations prematurely

• Personal assaults on the job and threats of violence

• Low salary

• limited advancement opportunities

• Lack of emotional support from supervisors

• Intense media scrutiny

• Risk of law suits