Creating a culture of resilience for social workers

Sarah Rose (University of Edinburgh)

January 2021

Acknowledgements

This Insight was reviewed by Helen Allbutt (NHS Education Scotland), Alistair Brown (Independent Social Worker, Consultant and Trainer), Jim Greer (University of Cumbria), Pearse McCusker (University of Edinburgh), Paula McFadden (University of Ulster), Neil Quinn (University of Strathclyde) and colleagues at Scottish Government. Comments represent the views of reviewers and do not necessarily represent those of their organisations. Iriss would like to thank the reviewers for taking the time to reflect and comment on this publication.

Key points

- Emotional resilience is broadly about coping with adverse situations

- Although common in human beings, resilience is not infinite and can fluctuate

- Personal coping strategies are an important aspect of emotional resilience, however, the concept has been used to place blame on individuals for their ‘failure’ to cope

- It is important to recognise the role of external factors in enhancing or undermining resilience. Organisational culture is one such external factor in the social work profession

- There are key tensions in the organisational culture of social work that can increase stress and undermine resilience. Addressing these tensions can help to create an organisational culture that supports the resilience of social workers

Introduction

As I write this Insight, the world is in the midst of the COVID-19 pandemic with countries easing their way in and out of varying degrees of lockdown, which requires people once again, to adjust to a new way of living. This is the essence of what emotional resilience is about: the capacity to adapt in times of adversity and ultimately, perhaps, to grow and flourish. This may be in unexpected situations of crisis such as the world currently faces, or in response to more frequent everyday stressors (Crane and Searle, 2016).

Social work is widely recognised as ‘emotional work of a high order’ (Howe, 2008, p1) and the impact of stress on the workforce is well researched. While individual coping strategies which equip social workers to manage the pressures of their role may be useful, the concept of resilience has met some resistance, with accusations that it is a neoliberal construct which places blame on the individual when they are unable to cope. An increasingly social justice approach has been taken by some, and the spotlight placed on the pressures created by structural factors of policy, procedure and resources (Garrett, 2015; Hart and colleagues, 2016). The specific impact of team and organisational culture on the emotional resilience of social workers has more recently been given attention (McFadden, Mallett and Leiter, 2018; Thompson and Cox, 2020).

In this paper, I briefly outline the concept of emotional resilience and consider how the policy and practice of social work in Scotland may influence the development of organisational cultures, and impact on the resilience of social workers. I draw on particular cultural tensions between managerialism and relationship-based practice, rationality and emotion, and professional integrity and ethical compromise, and explore how social work organisations can move from a culture of stress to one of resilience.

Concepts of emotional resilience

The evidence suggests that emotional resilience is thought to be common (Masten, 2001) and is not only observed in ‘rare and exceptionally healthy individuals’ (Bonanno, 2004, p20). There is broad consensus that it involves positive adaptation to or coping with adversity. A popular metaphor for resilience is ‘bouncing back’ (Grant and Kinman, 2013; Rajan-Rankin, 2014). This suggests that resilience involves recovery from adverse situations; usual emotional functioning may be disrupted but recovery is quick and complete (Tugade and Frederickson, 2004). Conversely, others suggest that it is not about recovery but about the ‘ability to maintain a stable equilibrium’ (Bonanno, 2004, p20). Youssef and Luthans combine the notions of recovery and stability somewhat in suggesting that resilience concerns ‘reactive recovery’ following an adverse event alongside ‘proactive learning and growth through conquering challenges’ (2007, p778), which enables greater coping capacity in the future. Although post-traumatic stress can occur following an adverse event, so too can post-traumatic growth (Fletcher and Sarker, 2013).

Resilience is increasingly understood as a dynamic concept that includes both vulnerability and protective factors, which mediate the way in which adversity is experienced (Luthar and Cicchetti, 2000). It is not merely 'the possession of a robust temperament' (Howe, 2008, p107) and may fluctuate depending on the context and external resources available (Pooley and Cohen, 2010). Certainly, some skills and traits appear to support resilience such as self-esteem, self-awareness, autonomy, optimism, humour, positivity, enthusiasm, critical thinking and social skills (Grant and Kinman, 2013), but these are unlikely to engender high levels of resilience without external support. Ungar (2018, p16-17) draws on the Cinderella fairytale as an analogy for real-life resilience:

The problem with Cinderella stories is that they make success seem to be all about the personal qualities of exceptional people. They epitomize the myth of the exceptional individual and conveniently overlook the deficits in the environment that surround their protagonists. The heroes and heroines look so beautiful, talented and self-assured that we forget about the supports that help them escape terrible situations. The story of the resourced individual is hidden in the footnotes.

One of the main critiques of resilience is that it can ‘make a bad situation worse by pathologizing and thus disempowering’ people (Thompson and Cox, 2020, p10). This may lead to blame being attributed to the person who ‘fails’ to cope, thrive and bounce back (Hart and colleagues, 2016; Webster and Rivers, 2018) and draw attention away from the need to address adversity arising from structural inequality (Garrett, 2015; Hart and colleagues, 2016). Indeed, ‘continued onslaughts from the environment can disable the strongest’ (Luther and Cicchetti, 2000, p863).

Emotional resilience is important for social workers given the high rates of burnout and stress leading to problems with staff retention and turnover (McFadden, Mallet and Leiter, 2018; Ravalier and Boichat, 2018). So, what aspects of organisational culture can support resilience and enable rather than disable social workers to cope and thrive in their professional roles?

From a culture of managerialism to a culture of relationships

Three decades ago, the NHS and Community Care Act 1990 significantly changed the way in which social services are delivered. Service users became consumers in a mixed economy of care with social workers assessing needs and arranging appropriate support. A culture of managerialism emerged, characterised by efficiency, economy, targets and performance indicators (Scottish Executive, 2006; Collins, 2008; Stanley and Lincoln, 2016). More recently, the personalisation agenda, implemented by the Social Care (Self-Directed Support) (Scotland) Act 2013, has again changed the nature of assessment and service provision, with service users gaining more control over how their support is managed and delivered. While the ethical basis of self-directed support resonates well with core social work values of service user empowerment, social workers report an even greater level of bureaucracy and a degree of cynicism about its use by local authorities to impose budget cuts (Pearson, Watson and Manji, 2018). Such a misalignment of organisational and individual values can increase stress and negatively impact on resilience (Rajan-Rankin, 2014).

While many social workers value the opportunity to build relationships with service users and cite this as their main motivation for becoming a social worker, it does not always sit well within a managerialist culture (Ingram, 2015). Deadlines take precedence over taking the time to build relationships with service users in order to gain a deeper understanding of their situation (Dwyer, 2007) and greater priority is given to organisational outcomes; a tendency also noted by Clapton (2020, p1):

The deployment of outcomes can serve as a seeming assurance of efficiency. This is to the detriment of less technocratic, softer, more uncertain, yet more realistic and humanist, efforts to describe change and growth.

In my ongoing research (Rose, 2020) into emotional resilience, many of the social workers I interviewed protested that they were not ‘robots’ but ‘human beings’. That the humanity of social work is perceived to be somewhat overlooked is perhaps surprising for a welfare profession.

This shift in balance from direct contact with service users to office-based tasks has been exacerbated by austerity measures implemented in recent years. Although councils have a duty to assess social care needs under the Social Work (Scotland) Act 1968, national eligibility criteria have been introduced to direct increasingly scarce resources to people most in need. Many local authorities in Scotland have made a decision to provide services only to those deemed to be in ‘critical’ or ‘substantial need’ (Scottish Government, 2014), which leads to social work practice becoming more reactive and crisis-based (Audit Scotland, 2016; Unison, 2019). This is despite the intention to focus on preventative services set out in a recent strategy report (Scottish Government, 2015). Crisis work, by its nature, does not allow time for social workers to build relationships with service users.

While there is no sign that budgetary restrictions will abate, particularly with the uncertain trajectory and ongoing financial cost of the COVID-19 pandemic, a clear work allocation policy can support a positive organisational culture (Stanley and Lincoln, 2016). Caseloads that balance short-term crisis responses with the opportunity for social workers to engage on a longer-term basis with service users, or be involved in preventative work, may contribute towards a more resilient culture by decreasing the dissatisfaction that can arise through a focus on bureaucratic procedures. Workload management tools such as those jointly developed by SASW and UNISON (Turbett and Stevenson, 2009) provide a practical guide. More explicit recognition by managers and policy-makers of human engagement as a social work intervention, may support a resilient culture where social workers feel skilled and satisfied in their roles. The rhetoric of ‘outcomes’ could be critically examined by organisations at all levels to determine what bureaucratic processes achieve in practice and exactly whose priorities are being met. As one of the participants of the research commented, ‘I’ve never had a service user say to me, you didn’t tick my box properly’ (Rose, 2020).

From a culture of rationality to a culture of emotional expression

Although social workers may regret the lack of interaction with service users, there is little illusion about the challenging nature of engaging with individuals and families who are often particularly vulnerable or disadvantaged. The ability to empathise is expected of social workers but over-empathising may lead to vicarious trauma (Kinman and Grant, 2011) and compassion fatigue (Fahy, 2007; Grant and Kinman, 2013). Hochschild’s theory of emotional labour (1983) recognises the need, in some professions, for employees to manage their emotions in order to display the kind of emotion expected of them by the organisation for which they work. Either a genuine attempt is made to feel the required emotion in a process of ‘deep acting’ or instead ‘surface acting’ is performed as an outward display of it. Hochschild concluded that the risks from emotional labour are burnout from over-identification with the work, guilt about under-identification, or detachment leading to cynicism and demotivation. Although Hochschild’s study was specifically in relation to flight attendants, a study of social workers in Denmark found that emotional management led to similar feelings of emotional exhaustion and self-alienation (Moesby-Jensen and Nielsen, 2015).

Despite the emotional impact of the profession, social workers do not always feel it is appropriate to express their emotions at work for fear of this being seen as a personal failure to cope (Van Heugten, 2011; Grant, Kinman and Alexander, 2014; Rajan-Rankin, 2014). As far back as ancient Greek philosophy we find Plato proposing that emotion and reason are two horses pulling us in opposite directions and, in many organisations, reason is valued more highly with emotion considered to be an interference (Fineman, 2000). Social work is a prime domain for these tensions to play out, dealing as it does with the emotional nature of working with service users in the context of large bureaucratic organisations. In this culture, the creation of ‘battle lines’ can emerge between emotion and social work practice (Ingram, 2015, p27). Since ‘bureaucratic organisations do not eliminate emotion’ (Rogers, 2001, p185), it is incumbent on them to develop an ‘emotionally intelligent’ culture that supports emotional awareness and expression (Rajan-Rankin, 2014).

Van Heugten advocates a culture shift in social work towards a recognition that being honest about one’s emotions is ‘a mark of professionalism, rather than personal failure’ (2011, p11). To support a resilient culture, opportunities for social workers to openly share emotions can help to reduce the ‘stigma of emotional disclosure’ and support resilience (Grant, Kinman and Alexander, 2014, p885). Social workers often respond well to being listened to by managers and supervisors, and this can facilitate a processing of emotion to avoid unhealthy repression (Dwyer, 2007). Supervision in a managerialist social work culture can, however, be predominantly task-based. Emotional support has been recognised as one of the core elements of supervision as far back as Kadushin’s model in 1976, alongside education and administration, and space could be designated either within regular line manager supervision sessions or as a distinct entity. Greer (2016) suggests that supervision from an external source could be made available by the organisation particularly if the worker does not have a relationship of trust with their line manager.

In a previous study, emotional support from peers was felt to be invaluable as a way to express emotions in a non-hierarchical setting by the social workers interviewed (Rose and Palattiyil, 2018). It takes away the complexity of balancing the dual roles of management and support that supervisors have to strike. Structured peer support may be useful as long as it is genuinely endorsed by the organisation and time is made available. Given the uncertainty and increased anxieties around the COVID-19 pandemic, various forms of emotional support may be all the more important at the present time, however, perhaps more difficult to execute given physical distancing. This could be proactively offered in the form of online peer group and individual support, to replace the spontaneous opportunities that would likely arise naturally when working in shared offices, and to reduce the stigma that might be felt by social workers who ask for it.

From a culture of compromise to a culture of professional integrity

Despite the vision for a ‘skilled and valued workforce’ presented in a report by the Social Work Services Strategic Forum (2015, p5), 59% of social services workers in a study carried out by Unison Scotland (2019) stated that morale in their team was poor or very poor. Kearns and McArdle suggest that resilience is closely related to a sense of identity and to how ‘personal, professional and organizational dimensions may be experienced in integrated and healthy ways’ (2012, p385). Social services workers and employers in Scotland are required to abide by the Codes of Practice in order to retain professional registration (Scottish Social Services Council, 2016), which could be assumed to provide a clear ethical framework for social work practice and cohesion with organisational values. However, the current climate of social work appears to require practitioners to compromise some aspects of their ‘professional integrity’, defined by BASW as the ‘responsibility to respect and uphold the values and principles of the profession and act in a reliable, honest and trustworthy manner’ (BASW, 2014, p9).

The managerial culture of social work not only poses challenges for relationship-based practice as discussed above, but it can also subvert a sense of positive professional identity. The rigid procedures often set by bureaucratic priorities can undermine social workers’ expertise and stifle autonomy (May and Buck, 2000; Grant, Kinman and Baker, 2015). Social workers who are acutely aware of the need to meet targets and deadlines can find themselves in a ‘bureaucratically preoccupied state’ which leads to a lack of engagement with service users, and a superficial and less skilled assessment being carried out (Ferguson, 2017, p1019). A sense of professional integrity can be compromised as tasks that are ‘auditable’ are preferred, in a managerialist culture, over ‘being a morally good practitioner’ (Banks, 2004, p21). Dual roles of, for example, supporting service users emotionally alongside assessment of their financial situation potentially creates conflict (Rose and Palattiyil, 2018); a key factor in the erosion of emotional resilience according to Rajan-Rankin (2014). Social work practice during the COVID-19 pandemic raises specific ethical issues, for example in decisions regarding further rationing of increasingly limited resources (BASW, 2020).

To support resilience, professional integrity can be maintained by challenging aspects of a procedural system that disadvantage service users, although this requires ‘courage and a sense of solidarity’ (Rogers, 2001, p32). Peer group discussion can provide a forum for practitioners to reflect on these kinds of ethical challenges in a non-hierarchical and power-balanced setting (Carson, King and Papatraianou, 2011). As social work practitioners are best placed to share ideas about what works in practice, open consultation between senior managers and frontline practitioners is also important, as long as it is not tokenistic and provides a genuine opportunity for social workers to be heard and to influence policy and practice (Greer, 2016). In ongoing research, however, it appears that this is more nuanced and that some filtering by middle managers of the flow of information from senior managers to practitioners is important to avoid overwhelm (Rose, 2020).

Other challenges to professional integrity have arisen within the process of integration of health and social care, which was made a requirement by the Public Bodies (Joint Working) (Scotland) Act 2014 for adult services, with local discretion to include children and families, and criminal justice services. In principle, the aim of integration is to provide more seamless services for the benefit of patients and service users. In practice, it has brought together the two very distinct cultures of health care and social care, and some resulting challenges. A recent report on the progress of integration recognised that cultural differences between the two disciplines are having a negative impact on its success (Audit Scotland, 2018). In current ongoing research, many social workers perceived integration to be a ‘health takeover’ with the distinct culture and contribution of social work under threat (Rose, 2020). This is mirrored in Ravalier and Boichat’s study (2018), which found that a lack of understanding of the social work role was the most prevalent cause of stress among social workers. A greater mutual understanding of the different disciplines would contribute towards a more resilient culture in which health and social care professionals genuinely work together and not merely alongside each other in pseudo partnership arrangements. The irony is that closer working relationships could be proposed as a way to foster this understanding but has in fact appeared to do the opposite in some cases. Joint training away from the immediate pressures of the workplace may help different disciplines develop a greater understanding of, and respect for, each other’s distinct contributions and priorities, and a sense of empathy for their challenges.

From a culture of stress to a culture of resilience

Social work is undoubtedly a demanding profession. Practitioners are vulnerable to stress (Kinman and Grant, 2011; Van Heugten, 2011) and experience high levels of burnout compared to other occupations (Collins, 2008; Grant, Kinman and Alexander, 2014; McFadden, Mallett and Leiter, 2018). While organisations are often portrayed as ‘bland portraits’ devoid of emotion (Fineman, 2003, p1), there is often an ‘emotional backcloth’ that carries the imprint of its history (Fineman, 2000, p13). If the emotional backcloth of organisational culture is one that views high stress levels as an innate aspect of social work, there is a risk of tolerance to it remaining unchallenged as it becomes more deeply embedded in the culture. High stress levels lead to problems with staff retention, which creates further stress due to its impact on the stability of the team, the opportunity to develop peer relationships, and higher workloads due to staff shortages (McFadden, Campbell and Taylor, 2015).

I have been struck by comments from social workers that appear to normalise stress (Rose, 2020). Some have expressed a belief that they must be doing something wrong if they are not frequently driven to tears, or that it’s ok to cry in the corner because every other social worker is too. If stress is seen as a personal issue and the organisational impact overlooked, it is likely to remain unaddressed (Van Heugten, 2011); tears will continue to be wiped away without attention to their underlying cause. Focusing only on the individual’s capacity to cope and bounce back is unlikely to create a culture of resilience in which structural factors are acknowledged and addressed and a collective sense of resilience developed.

Adopting a culture of resilience requires a recognition of the very real tensions and challenges in social work practice outlined here, and which are likely to be exacerbated by austerity and potentially the ongoing impact of the COVID-19 pandemic. Alongside this recognition, organisations can attempt to create a new emotional backcloth that values the wellbeing of social workers, addresses their concerns, listens to the wisdom from the frontline and enhances opportunities to carry out their role to support service users in ways that are positive, fulfilling and meaningful.

Implications for practice

1. A resilient organisational culture values and makes time for workers to build relationships with service users through workload management, opportunities for longer-term preventative work, and rethinking the emphasis on organisational outcomes and performance indicators.

2. Emotional expression by social workers should be seen as a sign of professionalism, and spaces created for emotional support such as designated time in line manager supervision, external supervision arranged by the organisation, or structured peer group support. This should be offered proactively rather than social workers having to ask for it and risk feeling stigmatised for doing so.

3. As professional integrity is an important aspect of resilience, any threats to it such as role conflict, ethical conflict and lack of clarity of role should be addressed in order to support a resilient culture. Peer support can help to build a sense of solidarity and unravel these conflicts alongside open and responsive consultation with managers and senior managers. Joint training with colleagues from other disciplines may help to foster mutual respect and understanding.

4. Chronic stress of social workers should be seen as an endemic organisational issue to be addressed. The root cause of this should be tackled rather than placing an expectation on individual social workers to ‘recover’ sufficiently to resume work in the same challenging conditions.

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