Tending the Caregivers

Mothers who work as healthcare professionals – physicians, physician assistants and nurse practitioners – can significantly reduce their stress levels and burnout by participating in close supportive groups at work, according to a new study by researchers at Arizona State University and the Mayo Clinic. The shared experiences in these support groups provide a wealth of nurturance for the women.

The study, “Fostering resilience among mothers under stress: ‘Authentic Connections Groups’ for medical professionals,” is published in the current issue of Women’s Health Issues.

Groups in the intervention provided “comfort, solace and advice as needed, building what some called a ‘secret sisterhood’ of shared experiences with genuineness and reciprocity in the relationship,” said Suniya Luthar, a Foundation professor of psychology at ASU and the lead author of the study. “These factors help build resilience for professional mothers who are under great daily stress, with substantial dual demands at work and at home.”

Senior co-author and collaborator on the project was Dr. Cynthia Stonnington, associate professor and chair of psychiatry at the Mayo Clinic College of Medicine, Arizona. Other authors of the paper are Alexandria Curlee, an ASU graduate student; Susannah Tye, Department of Psychiatry and Psychology at the Mayo Clinic, Minnesota; and Judith Engelman, a psychiatrist in private practice.

“Women medical professionals who are mothers often face the dual role of being the primary caregiver both for their patients and their children,” said Stonnington. “This puts them at higher risk for burnout than their male counterparts. Our study investigated how this supportive program might help mitigate stresses and promote their day-to-day health and well-being.”

The Authentic Connections Groups (ACG) intervention involved weekly sessions at work over a three-month period. The researchers randomly assigned 40 women at Mayo to one of two groups: either the 12 weekly one-hour sessions of the ACG’s or 12 weekly hours of protected time to be used as desired. The study was supported by a Seed fund from Arizona State University to Luthar, and the Mayo Clinic contributed release time to participate.

The study had several positive results.

It showed that those who participated in the ACGs had significantly greater reductions in depression and other global symptoms of stress than those given free time (the control group). Secondly, relative gains were still more pronounced three months after the program ended. Follow-up assessments showed significant between-group differences not only on depression and stress, but also on almost all other central variables, including parenting stress, self-compassion, feeling loved and physical affection. Participants in the ACGs also showed more reductions than control moms in cortisol levels (a biochemical indicator of stress) at both post intervention and three months follow up.

In explaining why this program worked, Luthar said that, in essence, the ACGs actively and continually fostered the development of close, mutually supportive relationships, and the resulting shared experiences and bonding helped to lower participants’ stress levels.

“Resilience research clearly shows the critical protective power of reliable close relationships,” Luthar said. “In this program, our focus was on developing and strengthening what we called ‘go-to’ committees for each woman. As topics were shared in the weekly group sessions over time, the moms each also shared them with their respective go-to’s. By the end of three months, each woman had developed great closeness not only with other moms in their work setting but also with at least two or three other women in their personal lives.”

A critical factor in enabling this effort was the institutional commitment to wellness. Stonnington reported that the ACG program was implemented as part of an initiative begun in 2015 at the Mayo Clinic in Arizona to address burnout and turnover among female physicians.

“Another major reason for the success of this program is that the groups were implemented in the women’s everyday settings, during their regular work-days,” said Luthar. “That the Mayo administration gave them the one hour per week free time to participate was a critical consideration, given how very packed these women’s schedules can be.”

The U.S. Surgeon General recently stated that efforts to promote the well being of medical professionals must become a major priority among health care organizations. This study demonstrates that facilitated colleague support groups can provide a viable, low-cost preventive way to mitigate burnout among women medical professionals who are also mothers.

More broadly, the authors note that the ACG program has the potential to be widely used in workplace wellness programs, given the high cost of worker stress and depression in contemporary America. Since completion of the Mayo project, Luthar and colleagues have successfully completed groups with military mothers, and are now offering it to women in the STEM (science, technology, engineering, and mathematics) disciplines, with both new projects implemented at ASU.

“It is our hope that over time, the ACG program will come to benefit women, mothers, and other adults in salient caregiving roles, as they routinely give so much of themselves to others while experiencing high everyday stress,” Luthar said. “It just makes common sense. Those who serve as first-responders, and who offer so much tending for many others, must themselves be tended – with this happening on a reliable and ongoing basis.”

Top 4 Ways to Improve #SocialWork

big-change

Recently, I wrote an article entitled, The Top 5 Reasons Social Work is Failing, which has become one of the most read and searched for articles on Social Work Helper since its inception. Whether you agree or disagree with my reasons, we all can agree that social work has some serious issues that must be addressed in order to improve outcomes for social workers as well as the perceptions of our profession with the public. Social work institutions are not providing adequate resources or responses to assist social work students and practitioners engaging or who want to engage in grassroots organizing, social justice advocacy, and public policy reforms.

Part of the job of a social worker is to assess and define the problem, but the other part of our job is to look for interventions to implement in order to limit the effects of the problem while adding protective factors to help increase outcomes. In an effort to be solution focused, I went on search to find actionable interventions that we could implement without needing an “Act of Congress” to get the ball moving. Social workers are the first responders to society’s social problems because we engage people from birth to death in all aspects of their life.

As a social worker, I have counseled an oil executive whose life was failing apart, an engineer after an all night drinking bender, a school teacher contemplating suicide, a man who has taken his family hostage at gun point, and a woman who was shot by her partner to name a few. Pain is universal, and it is not limited by socioeconomic boundaries which is why its imperative for social workers to be apart of the conversations developing public policy.

For Students 

As a future practitioner, you will not be able to work in a vacuum which means you will have to interact with other disciplines in order to be effective in practice. However, social work students rarely interact with disciplines outside of their programs or with social work students from other schools. By working in concert with other disciplines at the higher learning level, we are our best examples of how social work skills translate into other areas.

RICNDue to our isolative nature, what opportunities are we not taking advantage of that will serve us later in the workforce? It’s great to have social work clubs and organizations to increase collaborations within our profession, but it is also equally important to form partnerships and collaborations outside of the profession.

For students, I recommend seeking out the Roosevelt Institute Campus Network at your university, or starting a chapter if your university does not have one.

According the Roosevelt Institute Campus Network Website,

Campus Network develops local laboratories of democracy and policy experimentation where young people can work with community members to innovate, scale, and replicate the best ideas and policy initiatives emerging from our generation.Students have changed policies around predatory lending; established a tax fund in New Haven capable of sending every high-school graduate to college tuition free; and even included an automatic healthcare enrollment policy in the Affordable Care Act. Read More

Don’t miss out on available workshops, fellowships, and connections with community partners because you are afraid to step outside of our social work bubble.

For Practitioners

In school, most of the time, you have access to a support system through your professors, peers, and other services. However, once you enter the profession, it feels like your professional support system diminishes. Many schools don’t dump a lot of resources into developing strong and thriving alumni networks in order to maintain connections to former students that will allow us to interact with each other. Many social workers, especially those on the lower end pay spectrum, may not be able to afford access to a professional association membership or costs for conferences to gain those connections.

alumnifyMany social workers have turned to social media in attempt to forge those connections, but most would prefer an option for these connections to be an extension of their university community. Social media constructs like Linkedin are not designed for you to connect with each other within a Linkedin Group. How do you find alumni in your area when you are looking for a mentor or trying to expand your network for possible employment opportunities?

For practitioners, I recommend to request that your School of Social Work add an Alumnify Network for its graduates.

According to the Alumnify Website:

Alumnify will give alumni the ability to sign in with LinkedIn and receive data on their professional career and interests. It will allow graduates to find each other in their immediate area, making it as easy as possible to grab coffee and network. Alumnify also provides interactive and modern data that helps universities reach your alumni and understand them like never before. Read More

Currently, Schools of Social Work are making important school policies based on a couple of  hundred surveys they can get people to answer. Alumni get tired of the robocalls and email requests only they want something, and we begin to tune them after the second year we leave school. Why wouldn’t they implement a mutually beneficial system which could be free to users or for a modest fee to offset cost?

For Schools of Social Work

If we are going to advance our profession, we need to be engaging in the national conversations and social issues of our day. Social Workers are attempting to find ways to do this on their own, but utilizing social media improperly can have the opposite intended effect. Earlier this month, I wrote another article on how to reduce risks to employment when using social media where I stated,

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As a profession, we can not begin the journey of leveraging online technology and social media to advance social work because we are stuck having conversations about account creation, security, and ethical use. These things should always be ongoing conversations, but we have got to start making advances in tech education and training.

Agencies, associations, and social work faculty can not adequately answer or provide solutions because most don’t use social media or they utilize outside firms to meet their social media needs. There is nothing wrong with contracting out to meet the needs of your organization, but we must also have mechanisms in place to address social workers’ technological IQ at the micro and mezzo levels. Read More

Social Workers should be engaging in national awareness campaigns which can provide many opportunities to showcase our areas of practice and engagement on social policy issues.  Schools of Social Work should be leading the charge, and when used properly, these could become valuable marketing tools for your university while engaging community stakeholders.

If anyone is interested, take a photo or do a vine using the hashtags #TurnOutForWhat and #SocialWork telling why you are turning out to vote on November 4th. Then, tweet to @swhelpercom, share on SWH Facebook Fan Page, or tag me on instagram. I will be happy to share and promote the issues that you care about.

Learn How to Use Twitter Effectively

When I first started blogging, twitter was the number one tool I used to connect with people. In turn, I credit Twitter as the number one factor in growing Social Work Helper’s readership. Unlike other social media platforms, Twitter does not place limits on who you can follow, who can follow you, or who you can tweet to.

If you decide to tweet a member of Congress or parliament, you may actually get a tweet back. Some of my twitter highlights include a tweet from the Oprah Winfrey Network and being retweeted by the US Department of Labor and Mary Kay Henry, President of the Service Employees International Union.

As an individual, you don’t have to wait until #socialwork get its act together and do a better job at promoting the profession. This is something that we can start doing today.

Social Workers, Watch Your Language

How often do you stop to check the words you’re using with client groups, whether verbally or in writing? Are you sure that you’re using a commonly understood language? Or have you slipped into the comfort zone of everyday “colleague speak” when communicating with your clients? At the root of every social work intervention, micro or macro, is communication. Communication is an interesting mix of words and non-verbal cues.

JARGON PICThis is one of the most basic learning curves in our early social work training. We’re taught all sorts of aspects of effective communication such as how to establish rapport, how to structure a sentence so that the question is “open”, what active listening involves and even how to place seating arrangements to avoid barriers.

We spend months learning how to facilitate groups, identifying roles that participants take on, learning skills to redirect conversations, applying conflict resolution skills and ensuring we maintain a cohesive group where everyone benefits from participation.

We also learn how to gather interested stakeholders to lobby for community justice solutions, empower community groups to represent their views to significant bodies and write reports to further the cause and inspire collective action.

All these processes require effective communication skills. And most social workers pride themselves on their communication skills.

When reflecting on practice, how often do we focus on the actual words we’re using?  The words we string together when interacting with our clients. Somehow, through our social work education and consequent experience in the sector, we start to use words that the sector understands but can fail to convey meaning when it comes to many client groups. Not only do we use terminology that is foreign to our client groups, we actually forget how and when to use “plain speak”.

When someone speaks to us in a language we’re not totally familiar with, there is a shift in focus  on trying to understand the words, as opposed to listening to the message that is being conveyed. At best it’s a distraction, at worst a barrier to understanding.

SOCIAL WORK JARGON

What are some examples of social worker jargon?  For starters, there are so many acronyms in both service language and diagnostic language I’m surprised we understand each other: “Mr and Mrs Brown state they are having issues with parenting, mother has diagnosed BPD but no current treatment, eldest child diagnosed with ADHD. Recommend referral of mother to GP for a MHCP,  both parents advised to contact local C&FS for support and Triple P, and check possibility of vacancy in OOSH for eldest child.”

How many social workers have suggested in conversation to their client that they make an appointment with their GP ? What happened to the word “doctor”? Yes it’s easier and faster to abbreviate titles and labels in reports and in rushed conversations with colleagues. But isn’t it ironic that we express concerns at the social media trend of abbreviations such as LOL, OMG and ROFL yet continue to add more acronyms to our professional vocabulary?

Besides acronyms, what about some of those words that we use every day? Words that are part of daily life for us but confusing for client groups? Examples are   Intervention, advocacy, rapport, consumer, resilience, empower, auspicing  and engagement

Ask Joe Public what he thinks these things mean. Don’t be surprised if he  perceives “intervention” to mean “interfere”;  “to build rapport” is to write a report, “consumer” is someone who does the shopping, advocacy is a lawyer thing, resilience is about the strength of metal, community engagement is lots of couples planning a joint wedding, and auspicing is something to do with orphans. Yes, these are real responses!

THE NECESSITY OF JARGON

Jargon is expected in the formal realms of our profession. Report writing, funding submissions and academic reviews are just some examples.  Using complex language is almost a kind of intellectual segregation.  It says I’m educated, and additionally specifies my expertise in a certain realm. It’s a kind of “tribal speak” . My colleagues know exactly what I’m talking about, and by using this same “language”, I portray that I am worthy of being in this tribe called “social workers”. I prove my belonging by speaking native social work. It’s okay to mix in some native doctor speak if I work in a hospital setting, and some native psychiatrist speak if I work in a mental health setting.  I guess I could choose not to, but then I would not be taken seriously by these allied tribes.

But when I transfer this “social work native” language to those outside the profession, I have to remember that translation may well be required. After all, someone coming to me for support, who is already feeling vulnerable, does not need the added distraction of words they don’t understand.

BACK TO BASICS

In summary then, spend some time reflecting on the words you use when communicating with clients. Use language that most will understand. Keep it simple. By going back to basics, you will ensure that meaning is conveyed without doubt or misunderstanding.

Instead of building rapport, “get to know each other”; instead of talking about resilience let’s discuss “the ability to bounce back”; instead of engaging, we’ll “get together and work on some solutions” and instead of advocating let’s “chat to that person on your behalf”. For the sake of those we seek to support –  please mind your language!

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