How supportive teams can serve as a ‘protective shield’ against burnout

By Mark Wilberforce

Burnout is the result of a precarious balancing act gone awry.  On one side are the job pressures and demands on social workers which scarcely need rehearsing.  Many are intrinsic to a profession dealing with complex individual and family support needs, often against a headwind of deeper psychological, financial or social problems.

On the other side is the social worker’s perception of their ability to meet these pressures.  Armed with the requisite training, experience, personal qualities, and with the necessary resources provided in a supportive working environment, the social work role is challenging yet hugely rewarding. Some stress is natural, but when this is out of balance with the support available, the work can quickly become toxic to social workers’ health, and mental health in particular.

‘Defensive’

One key to maintaining this balance and keeping stress under control is having a sense of control over your day-to-day role, feeling able to make some judgement calls at your own discretion.  But a constant complaint is social work is being gradually stripped of this freedom by an increasingly defensive, reductive and prescriptive organisational framework.

There is a caricature of a social worker overwhelmed by paperwork, focused on enforcing stringent eligibility and financial criteria, rather than problem-solving with service users. With local authorities hit by austerity, an obsession with targets and budgets means the reigns are held tighter still while the workload mounts higher.

‘Us and them culture’

The danger is that an oppressive “us and them” culture may form, in which social workers feel unable or unwilling to voice concerns.  While similar tales may also be heard from other health and care professions, there is some evidence that the problem is most acute in social work.

The question is, to what extent this is all an inevitable feature of social work, and what, if anything, can be done?  A pessimistic view will point to research from before the age of managerialism, and find that many of these problems were alive and kicking even then: resources have never been sufficient, and senior managers never know what it’s really like out there.

‘Death-knell of autonomy’

Moving towards the present, evaluations of more recent reforms with the potential to change the working culture, such as personal budgets, have reported that ambitions of a reinvigorated, rewarding and innovative new direction for social work have not yet lived up to the original hype .

But a counterargument can, and must, be made.   First, some have queried whether the death-knell of professional autonomy has been exaggerated . Many skilled professionals have creatively found ways of wading through the bureaucracy of the social care system, to affect meaningful change in people’s lives.  Second, and at the risk of sounding naive, new opportunities for co-produced social work services feel like an exciting opportunity for breaking the cycle.  The piloting of social work practices for adults for example, has a budding evidence-base, offering potential for improved social worker autonomy.

‘Multidisciplinary endeavour’

That research also presented a challenge to the notion that the responsibility and decisions around a case must be held in a partnership between an individual worker and manager. Health and social care delivery is a multidisciplinary endeavour, and there is some indication that social workers in multidisciplinary teams enjoy greater freedoms and recognition, with reflective and open team meetings permitting healthier discussions of problems and solutions (albeit facing other challenges besides).  A recent study of social workers in community mental health services reflected positively on their perceived levels of autonomy compared to mainstream local authority work.

‘Protective shield’

Support from our teammates is a hugely protective shield from pressure, giving both advice and guidance and emotional support. An open, supportive and reflective team environment has a crucial role to play, and needs to be nurtured as such. A certain level of stress might be inevitable, but with the right support and working environment, burnout need not be.

Mark Wilberforce is an academic and National Institute for Health Research fellow at the University of Manchester