When social workers snap under pressure

During a chaotic home visit in 2007, social worker Anna Orlinski physically restrained a child. She was admonished by the General Social Care Council for inappropriate behaviour. In 2005, Frederick Keith Stockdale was suspended for two years for verbally abusing and physically restricting a woman with learning difficulties. Both cases were blips on otherwise unblemished professional histories.

But how often do social workers snap? It’s “not uncommon” for overworked social workers, who encounter aggression and abuse every day, to snap under pressure, says Kim Bromley-Derry, president of the Association of Directors of Children’s Services. “If service users are shouting and abusing you at the other end of the phone or in an office, then it’s incredibly difficult to remain calm and professional. Most of the time social workers do that brilliantly, but occasionally they do fall below the standards they would expect of themselves.”

Social work is a highly stressful job and, when stress builds up, many people feel unable to cope – and that is when they reach the point where they “snap”. The demands placed on social workers by their jobs can affect their ability to sleep, causing fatigue and physical illness, says Iain Bourne, director of Impact Training and Consultation, which runs courses on dealing with dangerous behaviour for social care professionals. This might mean they feel unable to continue with work, become negligent or reckless, or angry and irritable. “Often you snap about something small, but it’s really the cumulative effect of a lot of distressing situations,” says Ruth Cartwright, joint manager for England at the British Association of Social Workers.

People react to stress and aggression in different ways depending on their personality, underlying mental health issues and what is going on in their non-work lives, says Bourne. “They could hit out – laugh at their colleagues, attack management, sneer at their clients – or they could turn inwards and become depressed, physically ill, abuse alcohol or drugs.”

So what are the warning signs: steam coming out of the ears, an acute rise in blood pressure or a sudden nervous twitch? “Becoming more emotional is one,” says Cartwright. “Becoming a bit quiet and withdrawn, showing a bit less control than usual and perhaps seeming to overreact to problems.” The list can go on, but the changes seldom occur overnight: they are slow and insidious, and often go unnoticed.

One way to spot mounting stress is by putting in place effective supervision and support. “The stress it will cause a manager in having to deal with allegations of misconduct, negligence or abuse will outweigh the stress and effort put into ensuring a strong enabling supervision system,” says Bourne.

How to cope in the heat of the moment

1. Recognise the signs:

Be aware of any marked changes in your behaviour. Are you arriving late (or very early) to work? Do you look different? Do you feel isolated? Are you snapping at people and then apologising? Often people know they are near the end of their tether, but hope they can keep it together. “It is also important to be sensitive to the pressure your colleagues may be under, and offer to help if you can,” says Ruth Cartwright, joint manager for England at the British Association of Social Workers.

2. Don’t bottle it up:

Talking about difficult situations is not an admission of failure. “Give yourself permission to say the job is tough,” says Kim Bromley-Derry, president of the Association of Directors of Children’s Services. Social workers should be able to say “this is an incredibly difficult piece of work”. Managers should also offer an opportunity to let off steam. “There seem to be fewer opportunities now for people to ‘debrief’ after a difficult visit because colleagues are all on their computers,” says Cartwright. It’s important to take time out to talk through any issues.

3. Build a support network:

“We all have bad days,” says Bromley-Derry. “I haven’t personally snapped, but you do need to have techniques to help you cope – it may be you do stuff at home or have colleagues at work you talk to. If you’re having difficulties, have a mentor or a manager you can talk to. I don’t think it has to be your line manager. It needs to be somebody you have a good relationship with. It may be inside or outside work. But you can talk about the issues, talk about your own behaviour – and that applies even if you’re very experienced.”

4. Manage your stress:

Peter Totterdell, professor of psychology at Sheffield University, recommends forming a plan to pre-empt stressful situations. “If I feel annoyed, I will count to 10,” he says. This will help make that behaviour automatic in those situations. Other ways to manage your stress include physical activity and healthy eating.

5. Work-life balance:

Make sure you take time out of each day to recharge your batteries. Working long hours and taking work home can mean that people are not able to recover so well, with the result that they will start the next day with less energy. Spending time on other non-work activities or just relaxing can help. It’s important not to ruminate on the day. “Have a balance. Your whole life should not revolve around work,” advises Bromley-Derry.

Tales from the frontline

Ruth Cartwright, joint manager for England, British Association of Social Workers

“I once dealt with a case where a social worker told a [service user’s] family member to ‘f*** off’ on the phone. She had a heavy workload and the family was being very difficult. After it happened, the social worker was aghast and couldn’t believe she’d said it. She was practically in tears. Another member of the team rang the family back and apologised, explaining the stress the social worker was under and saying she would personally apologise later. I had every sympathy with how the social worker felt. There are service users who deliberately wind up social workers, and others who threaten social workers in order to get their own way. That can be hard to handle.”

Social worker on CareSpace

“I witnessed a colleague be vindictive and oppressive towards her clients, just because she was in a bad mood herself. She then got herself signed off with stress for a month, and has come back to a protected caseload. Now we’ve been instructed to take difficult calls for her. When a client gets angry because they haven’t received the service they were promised, she will start crying and refuse to speak to them. She went through a phase of freezing and sitting in silence in clients’ houses looking like she was about to bolt for the door. It is difficult for the manager to deal with when it comes to her attention because she needs workers to allocate cases to. In addition, the performance management process is complicated and long-winded. I wish the clients would complain more.”

Social worker on CareSpace

“I used to be a project worker in a hostel for ex-offenders. After a year and a half the team that I worked with left one by one, either for new jobs or through sickness and burn out. This left me as the only official worker in the hostel. I was also getting abuse from two service users on a daily basis. One day I walked into work to find the area manager waiting for me. She started to have a go at me about some work I hadn’t had time to do. I snapped and started to cry. I told her I couldn’t do the job and was going straight to the doctor’s, who then signed me off for three months and sent me for counselling. I did not receive any supervision at work, which I believe is extremely important for mental health. I would tell anyone feeling under pressure to let it all out, and, if you do not receive supervision, ask why not.”

This article is published in the 26 November 2009 edition of Community Care magazine under the headline When social workers lose it