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    Critique of Self-Care Initiatives in the Helping Professions

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    Generally speaking, helping organizations view humans from two polarized lenses.  Some organizations believe that their employees are good people and will always do their best despite any barriers that exist. Other organizations operate as if people are to be significantly controlled. These organizations believe without external control, people will give less than one hundred per cent and will somehow take advantage of benefits or in any way they can.

    If you consume literature from publications like Forbes, Macleans (Canada), Time, or even through social media, you undoubtedly have read about efforts of progressive companies to foster production and actually take care of their employees in a holistic manner. We now know about the benefit to production, whatever the product may be, when organizations implement wellness strategies at work and give employees menus of wellness options to choose from which briefly take them away from production to have infusions of wellness.  In fact, this opinion is no longer just an opinion.  The evidence is clear. Organizations and societies who take care of their employees fair better on every indicator of production.

    In the helping professions, our organizations are often well intended when they engage us in wellness conversations and efforts, but they often miss the mark. Helping organizations often bring in “experts” to talk to us at staff meetings. This act within itself is view as progressive and helpful. Again, while well intended, helping “experts” and their products miss the mark of what is needed to increase the wellness of helping professionals.  Why is this?

    Strategies and self-care models offered to increase our wellness do not fit the nature of our work.  These models are based on static and linear models of work and production. For example, ten minutes of stretching likely benefits a professional helper who works a strict schedule and sees clients in an office for treatment blocks.  One can certainly take ten minute breaks and will reap the stress reducing benefits from those breaks.  Strictly office based helpers can often also find time to exercise at lunch, socialize in the lunch room, and so on, and therefore reap the resiliency benefits of these strategies.

    The problem here is that the majority of helping professionals do not work in office based environments and see clients for therapy or for some other time specific service.  The majority of us work in child welfare, children’s or adult mental health, or crisis intervention environments.  Our “schedules” change several times a day as we meet the needs of our clients and respond to our communities’ crises.  A day in the life of a helping professional in these areas of practice looks more like a dog’s breakfast.  We don’t get set break times (they are there but we can’t and don’t take them because we are too busy), we don’t eat at set times and we almost always eat in our cars while travelling from situation to situation.

    We forget to pee and poop.  No really we do.  We experience the sensation to pee, but it is often an hour or two or three before we actually remember or have the time to go. To be sure, it is just not possible to interrupt a suicide assessment, crisis phone call, apprehension with the police, or the like, to pee.  Not only do we care so deeply about our clients welfare that we wouldn’t interrupt our process with them to pee, but we also get used to ignoring our bodily indicators and in fact over time we actually divorce ourselves from a great deal of our biology.

    This divorce from our biology often happens with ease because we are pumped full of stress hormones which naturally serve to put everything except the crisis at hand on hold.

    While I don’t mean to belabour this point, it would be negligent not to note that if you follow the logic about the physiological and biological separations we perform in order to meet the needs of our client populations, you will understand that implementing any menu option from the typical self-care menu is literally impossible.  You can’t meditate on the witness stand, during an apprehension, or a suicide assessment.  You can’t break for a jog when you spend your lunch in your care driving and eating.

    Following along with the logic of this work reality means that our self-care has to happen on our own time.  After work whenever that may be.  But if you’ve apprehended on this particular day, you are likely still at the office long after closing time.  You are settling the children at the foster home and then heading back to the office to prepare your court papers.  Your family, if you have one, doesn’t get to see mom or dad tonight because work responsibilities made that impossible.  The family may not get to see you tomorrow either because you may have to leave early for work in order to pick up your court papers and be able to serve them to your client family before court.

    There eventually comes a day though when you things “slow down”.   A slowdown of course refers to the day when you get to try and fit in all of thing appointments and other tasks that you have had to put off due to the crises you have been responding to.  On these days you still eat in your care, don’t get breaks, but… you likely pee more regularly.

    There seems to be a general understanding amongst us that if you are in this line of work for more than ten years you are a “lifer”.  I mean no disrespect to those that get out after a few years and in fact many of use envy you and are proud of you.  We still consider you one of us if you’ve been on the front line for even a few years before you leave because you “get it” and you are therefore one of us.

    The life cycle of a lifer is as varied as is a day in our line of work.  Sadly though, many of us lifers don’t fare so well in our own personal lives.  There are many reasons for this but for me based on my dedication to understanding the harmful effects of trauma, it boils down to the cosmic roll of the dice of our stress hormones, traumatic exposure both direct and indirect, and to the overall impact of our divorce from our biology and often our bodies.  Many helping professionals  get sick from our work.  We all know colleagues who have chronic illnesses that really boil down to the harmful effects of stress.  The academic literature is now abundant in this area so you don’t need me to tell you about it.

    The cost of our caring is too often too great.  I know we wouldn’t have it any other way but it is also not fair and just.  Given the strength of the literature in the area of trauma, burnout and compassion fatigue in the helping professions and the clear health consequences of chronic stress, I believe we can do much better in helping ourselves lead lives full of more wellness.  This requires a change in the structures of our work, it requires a change in organizational culture, and it requires a commitment of each one of us to be brave enough to talk about the cost of caring.

    Next, we need to change organizations that view employees as ultimately malignant.  People don’t choose to be sick and they don’t want to be sick.   To be clear, psychological and emotional illness is a real risk in our work.  And, psychological and emotional illness can lead to a myriad of legitimate physical ailments ranging from the common cold due to compromised immune systems to auto immune illnesses like irritable bowel syndrome.

    Organizations who view employees with suspicion are using faulty logic.  Not too long ago in my province we had a Premier who successfully waged a ware on welfare recipients by convincing the population that people on welfare are cheaters and have lazy characters. This of course is not true. People don’t choose to or want to be on Welfare.  Similarly, it is not flaws in our characters that make us ill.  We are not weak, and we do not need discipline to help us be more productive during times of illness.

    What we need is wellness initiatives that fit with the nature of our work. These initiatives need to be dynamic and individualized.  I believe that we need individual wellness plans which are akin to Individualized Education Plans for children in our school systems with learning needs. We need modifications at times and accommodations that reflect the true nature of the stress in our jobs.

    We cannot be expected to own our wellness when by its very nature our work often leaves us exhausted and without adequate time to rejuvenate. The ownership needs to be jointly held by us and our organizations, communities, and professional organizations.  We need nap pods, we need exercise equipment on site, and we need kindness which includes life affirming strategies aimed at reducing the host of risk factors are work puts us at risk of.

    We also need parity with other helping professions and service providers such as first responders – Police, Fire, and Ambulance. I’m not sure how this has happened but we have lost a lot of ground in this regard.  In many provinces and jurisdictions, Police officers now make six figures and have the benefit of early retirement at full pension.  Most urban Police stations and fire halls have onsite gyms.  I do not begrudge this, in fact I applaud it.  But, we are also first responders and we are by and large not a healthy population by any indication.

    Most importantly, we have to be clear about these truths. It is surely hard to admit that our work makes many of us ill in one way or another and by the very nature of our illnesses we want to avoid talking about them and truly addressing them.  We need to adopt real risk reducing strategies such as those employed by our Police partners. Can you imagine a Police officer attending a client home alone?  Working in partners is one of the most basic risk reducers available to us but we don’t have that option much of the time.

    The evidence is not just anecdotal and therefore should not be dismissed. What needs to happen now is for us to bravely open up global conversations and create global movements to address our wellness.

    Perhaps ironically, we are in fact a vulnerable population who are charged with serving, protecting and healing other vulnerable populations created by our society.  Society and systems create vulnerable populations, individuals do not create vulnerability in themselves.

    Leaders who are responsible for the wealth of research pertaining to the cost of caring in our areas of work need to collect and collate information regarding the positive effects of workplace culture in addition to wellness options where organizations own the efforts and reap the benefits of those efforts. And, we need to strongly advocate for the end of career benefits that our Police, Fire, and Ambulance colleagues experience.

    I believe we need an organization for social workers and helping professionals, a think tank of sorts,  whose purpose is to improve our lives at work and at home.  I’m sorry to have to say this but our professional organizations have missed the mark here.  More often than not, they exist to monitor and discipline us while protecting their interests. Who will protect and nurture our interests?

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    Clint is a Canadian Social Worker who earned an Honors Bachelor of Social Work (BSW) from Laurentian University and a Masters of Social Work (MSW) from McGill University. Clint is in his 20th year of Social Work practice with interest and expertise in macro and systems level analysis and intervention, domestic family violence, trauma, stress, and post traumatic stress, child maltreatment, and solutions to reduce the impact of trauma in the helping professions.

    Child Welfare

    Single Father Adopts Five Siblings from Foster Care System

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    Back in October of 2020, single father Robert Carter adopted a set of five siblings so that they would never again be separated by the foster care system. Robert became inspired to foster after being split up from many of his own brothers and sisters when he entered the system at the age of 12. Following his emancipation, Robert became legally responsible for two of his siblings, which inspired him to continue to expand his family. He became a foster father to three of the five siblings and quickly realized that it was his purpose to adopt all five children.

    A Systemic Issue

    There are currently over 400,000 children in the foster care system, two-thirds of whom have a sibling in the system as well.  Many of these children are separated from their siblings for reasons including a lack of families able to foster sibling groups, diverse needs of children and lack of resources for finding placements. Other siblings may be more likely to be separated by social workers due to myths that sibling sets will not integrate as well into a new family dynamic or that it is in the best interests of a parentified older child to be removed from their siblings. 

    Sibling separations, like Carter and his children experienced, often compounds the trauma that children in the system endure. In a foster care system where 63% of children are removed from their homes due to parental neglect, sibling relationships help to provide much needed stability and emotional support. These sustained relationships allow sibling sets to have greater success in school, better relationships with foster parents, more successful permanency outcomes, and better mental health. Yet, until the last couple of decades, the advantages of keeping siblings together were largely ignored from a policy perspective.

    Policy’s Influence

    In 2008 this changed when keeping siblings together became national priority when the Fostering Connections to Success and Increasing Adoptions Act was passed. This Act “requires a state plan to provide for reasonable efforts for joint placement of siblings in the same foster care, kinship guardianship, or adoptive placement unless it would be contrary to the safety or wellbeing of any of them.” This act also requires that children who are unable to be placed with their siblings be allowed frequent visits with their other siblings.  

    While sibling placement is defined as a priority on the federal level, states may interpret the implementation of a plan differently. As of 2018, only 37 states have statutes requiring these reasonable efforts to keep siblings together during the placement process. States may often vary in their definition of “sibling” as well. While children often define their siblings as those who grew up with them, including step-siblings, often state laws only define sibling relationships in terms of blood relations. 

    Certain states, such as Oregon, have a Sibling Bill of Rights to help protect children in the foster care system.  Some of these rights include being able “to live in the same home as (their) sibling if possible” and “to live with foster parents who are trained on the importance of sibling relationships.” Bills like these offer children autonomy and protection when entering the system so that they can advocate for themselves. 

    As laws continue to evolve to protect children in foster care like Robert and his kids, Robert hopes that foster and adoptive parents will step up to help keep families together. Here’s what he said in an interview with Aol.com:

    “A lot of people think you have to be married to adopt or be a foster parent. I want people to know: No matter the situation, as long as you have the means to take care of a child [you can] become a foster parent,” he explains. “We have so many kids still in custody, there are 400 kids in Ohio waiting on forever homes. And I am happy that I was able to help encourage and inspire other people to step up.” 

    Currently, over 100,000 children are to be adopted, many of which risk being separated from their siblings. You can help to keep these children together by becoming a foster parent for a sibling set and learning more about the adoption process

    If you are unable to adopt or foster right now, research your state’s sibling protection measures and help advocate for policies that support sibling reunification.

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    Child Welfare

    Protecting Children from Harm in the Context of Distance Learning

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    The nation saw an uptick in domestic violence calls in the midst of the pandemic and the shutdown. The convergence of social isolation, economic pressure, and psychological stress created favorable conditions for abuse to occur. Adults are not the only victims of abuse in the home. Children, too, are vulnerable. History shows that violence against children and child exploitation intensify under conditions of isolation and economic pressure. While the pandemic may be temporary, child abuse often has long-term consequences.

    School systems play a vital role in intervening in the lives of vulnerable children. In fact, schools make 21% of the reports to child protective services according to The Washington Post. When COVID-19 forced the schools to close, states saw a drastic drop in the number of children being referred to CPS. Unfortunately, this reduction did not mean that the incidence of abuse decreased. Indeed, as reports to CPS dropped, ER doctors saw a rise in more severe cases of abuse. Child abuse not only persisted, but it went unchecked during the shutdown. Without school personnel, community workers, medical and dental personnel, and other mandated reporters, there was no watchdog to report the abuse until children sustained injuries severe enough to warrant medical attention.

    Clearly, schools serve a vital function in protecting children from harm. Now more than ever, they need to be alert and responsive to abuse as children return to school virtually. Distance learning presents unique opportunities and challenges that should be addressed proactively. Social workers can and should play a leadership role in adapting child welfare protocols for distance learning and retraining school personnel to identify and report suspicions of child abuse and neglect. This article outlines a proposed curriculum for child abuse and neglect reporting in the context of distance learning.

    School personnel should be well-equipped to spot signs of child abuse and neglect in the context of distance learning. Asynchronous instruction affords teachers a glimpse into students’ homes. In addition to any disclosures of abuse, teachers should be especially attentive to:

    • Verbal threats of harm, hidden, unexplained, suspicious, and/or repeated injuries
    • Suicidal ideation in students
    • Sexually inappropriate behaviors or images
    • Weariness when an adult is present or approaches the student
    • Excessive dirtiness or lack of proper hygiene in the home or the student
    • Illegal substances or evidence of impairment in the caregiver
    • Evidence of malnourishment in the student

    School staff should also note that it is illegal under most state laws for children to be home alone unless they have demonstrated sufficient maturity, and there are safety structures in place. Young children should not be home alone. Furthermore, children with a record of behavior or emotional problems (e.g. frequent suspensions) should not be in the home unattended. Children who are able to be home alone should be able to access safe adults in case of an emergency, and there should not be hazardous conditions or items present. Children who can take care of themselves may not be mature enough or capable of taking care of younger children. School staff members play a critical role in monitoring these conditions. Clear steps should be outlined for reporting any safety concerns or suspicions in a timely and accurate manner to school personnel (e.g. principal, guidance counselor) and child protective services.

    Because teachers will be exposed to the live conditions of the home, they have to be prepared to respond to crisis situations. Crisis management in the context of distance learning is different from that in more traditional settings because the staff person is physically distant from the student, and there may not be another adult present with the child for reinforcement. As a result, they are at a disadvantage in terms of their ability to intervene.

    Still, there are measures staff can take to manage the crisis from afar. In the event of an imminent threat to the safety of a student, staff can adapt telehealth protocols such as:

    (1) call local 911/EMS while maintaining contact with the student

    (2) identify bystanders who may be able to assist by providing information, monitoring the student, and/or intervening, as appropriate

    (3) obtain the student’s physical location, an alternate contact in case of a disconnection or other technical issue, and contact information for the student’s caregiver

    (4) while maintaining contact with the student, contact the caregiver to advise him/her of the situation

    School personnel has an important responsibility in monitoring student attendance. Countless children can be lost to human trafficking and exploitation if schools falter in this duty. As such, the onus is on the schools to locate children who do not report for school. Students should be expected, at a minimum, to check in occasionally so that school personnel can check on their well-being.

    Finally, school administrators should be cognizant of the increased risk of exploitation by school staff when supervision and monitoring are lacking. Clear codes of conduct should be put in place or adapted to guide online interactions between students and school staff. Outside meetups should be prohibited unless they occur at school during school hours with proper supervision. Administrators should ‘‘float’’ from class to class to monitor interactions and conduct in the virtual classrooms. Caregivers should also be encouraged to monitor online learning. An adult should be present at all times during synchronous sessions to supervise and provide support.

    Schools play a critical role in protecting our most vulnerable population. Critical attention should be given to adapting child welfare protocols for distance learning so that school personnel can make the necessary efforts to be effective in this capacity under these unprecedented conditions. Social workers should proactively address this issue and retrain school staff in child welfare protocols.

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    Child Welfare

    Normal Childhood Behaviour Misconstrued and How Assessments Are Helpful

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    There is a quote attributed to Sigmund Freud, “Sometimes a cigar is just a cigar”. So too of childhood behaviour and incidents; they may be simply within the range of normal childhood life. However, in the context of high conflict separated parents, the simple explanation can get transplanted with extraordinary suspicions and theories.

    Normal childhood development has toddler-age children exploring their bodies, discovering the genitals and anus and taking pleasure from self-touching. They are at the toilet training stage of life and hence are drawn by normal parenting behaviour to attend to these body parts. In intact families as children are observed to engage in self-stimulation and genital play, they are simply redirected to either stop or to engage privately at appropriate time and place. In the context of high conflict separated parents, there is a risk to ascribe these childhood behaviours to sinister behaviour on the part of one of the parents. So a parent may inadvertently bring greater attention to the child’s behaviour and thus actually reinforce the concerning behaviour themselves while at the same time alleging sexual abuse at the hands of the other parent.

    As preschoolers, children take flight on playground equipment. They may be learning to ride their two-wheeler. Hence this is a time of childhood injuries, particularly bruises, bumped heads and broken arms. In the context of high conflict separated parents, a parent may be suspicious of child-abuse in view of injuries and use the situation to allege physical abuse or at least neglect. However, and again, even in intact families, children can get hurt; bump their heads and fall from bikes and playground equipment.

    As school-age children try to get their own way, they naturally try to pit parents against each other. They will use whatever strategy works. Kids may tell you that other kids are getting or doing what is desired or they may tell you that the “other parent” let’s them do as requested. In intact families, parents simply call their children on manipulative behaviour or at least check with the other parent to determine if what the child is saying is true. However, in the context of high conflict separated parents, a parent may take what a child says at face value and believe that the other parent is undermining their own parenting or the values of the child.

    In intact families or even between separated parents with good communication, normal childhood events tend not to escalate with suspicion and drama. Issues are nipped in the bud and children are redirected to appropriate behaviour. Injuries are attended to without additional fanfare. A parent may feel guilty for a child’s injury, but not blamed per se.

    In the context of high conflict separated parents, normal childhood behaviour and incidents can take on epic proportions. Otherwise, normal behaviour can lead to suspicion or be used against a parent to undermine care and custody. As one parent cries foul, the other cries parental alienation syndrome. The fight is on and heats up to the point of boiling over. The child is caught in the middle and their behaviour escalates as a result. Both parents then use the child’s behaviour as evidence of their own claim against the other.

    Here is where a good assessment is so necessary. The assessor will tease out normal from abnormal childhood behaviour and incidents and determine how much of a child’s behaviour is attributable to just the conflict between the parents versus truly sinister behaviour deliberately aimed at harming or neglecting a child.

    Parents beware though. Sometimes a cigar is just a cigar, despite suspicion.

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