Social workers across the UK are emotionally exhausted and battling to hang onto their compassion, but are still managing to achieve positive changes in the lives of service users, Community Care research has found.
The study, done in partnership with Queen’s University, Belfast, also revealed ineffective supervision is increasing the risk of burnout.
In what is one of the largest studies of burnout among social workers in the UK, a total of 1,359 people completed the Maslach Burnout Inventory (a world leading scientific measure), of whom 1,161 were either frontline or senior social workers. The majority of respondents (70%) had more than six years’ experience.
Respondents worked across all areas of social work including child protection, older people, mental health and service users with disabilities. Almost all worked in statutory settings (94%).
The study found high levels of emotional exhaustion in the majority of respondents (73%) with one in four (26%) reporting high levels of depersonalisation, which describes the process of becoming emotionally hardened towards service users.
However, despite this there were overwhelming levels of high personal accomplishment among almost all respondents (91%) and nobody felt they were never able to positively influence service users.
Social workers at risk
Lead researcher Dr Paula McFadden, of the School of Social Work at Queen’s University, said the average score for both emotional exhaustion and depersonalisation was above the cut-off threshold to be considered at risk of burnout.
However, she said the high levels of personal accomplishment found were highly positive for the social work profession.
“It is clear from these findings that despite the negative feelings expressed about their jobs, the sense of personal accomplishment and efficacy remains high, preventing social workers from burnout.”
Service users save social workers from burnout
Those who wrote comments on the survey said it was direct work with service users that saved them from burnout.
My service users keep me going
One respondent pointed out: “Some situations with service users are anxiety provoking; some involve risk and responsibility but for me the greatest stress and anxiety is largely from the agency I work for.”
Another said: “My issue is with the department and the torture they put us through. My service users keep me going.”
The high levels of personal accomplishment are even more impressive given the high rates of emotional exhaustion among social workers, which exceed the levels found among GPs and nurses.
A comparable study among GPs published in the British Medical Journal in 2012 found less than half (46%) of 500 GPs reported high levels of emotional exhaustion but a similar number (42%) had high levels of depersonalisation and 34% felt they never achieved any positive changes. A 2012 European study of nurses found 42% of UK nurses reporting high levels of emotional exhaustion.
Caseload complexity needs more investigation
The study also found high levels of emotional exhaustion reported across all sizes of caseloads, including those with less than 20 cases.
“This suggests that more research is needed to examine the complexity of cases social workers are holding,” McFadden said.
The results also showed a clear correlation between ineffective supervision and the risk of high levels of emotional exhaustion and depersonalisation.
Ineffective supervision increases risk
Among those who reported their supervision was ineffective, the risk of high emotional exhaustion increased from more than 1:2 (60%) to more than 3:4 (86%) while the risk of high levels of depersonalisation increased from 1:4 (24%) to 1:3 (35%).
Despite a common perception that child protection is the most stressful area of social work, the study found those working with adults with physical disabilities had the highest levels of emotional exhaustion (84%) and depersonalisation (36%) closely followed by those working in mental health (80% and 31% respectively).
Most (83%) respondents were women but the study found factors such as gender, caring responsibilities, whether supervision was by a social worker or not and years’ experience had no, or very little, impact on the risks of burnout.
The headline results of the study are available in PDF format to download. They have been sent to government ministers, MPs, directors of social services, and other policy makers. Queen’s University, Belfast will take forward more in-depth analysis on the results.
Maslach Burnout Inventory
The Maslach Burnout Inventory is a method of measuring self-reported feelings across the three domains of burnout.
Emotional Exhaustion: This domain measures feelings of being emotionally over-extended by one’s work. Questions such as “I feel burned out by my work”, “I feel like I’m at the end of my rope” and “I feel emotionally drained from my work” measure this domain.
Depersonalisation: This describes a lack of feeling and an uncaring response to service users. Questions such as “I worry this job is hardening me emotionally”, “I feel I treat some recipients as impersonal objects” and “I have become more callous towards people since I took this job” measure this domain.
Personal Accomplishment: This domain measures feelings of competence and successful achievement in one’s work with people. It is measured by questions such as “I have accomplished many worthwhile things in this job”, “I feel exhilarated after working closely with service recipients” and “I feel I am very positively influencing other people’s lives through my work”.
High levels of emotional exhaustion and depersonalisation accompanied by low levels of personal accomplishment indicate burnout. However, high levels of personal accomplishment do not negate high scores in the other two domains. Those who have high scores in emotional exhaustion and depersonalisation are still considered at risk of burnout.
Maslach et al (1996:10)
Where was the duty of care towards me?
*Jane, a children’s social worker tells her story
“I have just resigned from my social work post after 12 years working for children’s services because I was so unhappy. This was solely because of the insurmountable amount of work I had to cope with.
I was working relentless 12-14 hour days without breaks. I worked in the evenings on my own time; I worked on weekends; I even started my working day at 5.30am to try and keep on top of my deadlines.
None of it was enough. On one shift I had worked close to 20 hours with no break because I was asked to follow up on a crisis. I ended up coming home in the early hours of the morning absolutely exhausted and nearly had a car accident when my car hit ice and veered to the other side of the road.
My car hit ice and veered to the other side of the road
As my life flashed before me, I thought to myself where is the duty of care towards me as an employee? There was none.
I was working in a culture of fear and disempowerment, with an oppressive management structure.
Audits were about naming and shaming social workers, which is demoralising when you are working so hard and giving your best. Although the majority of my audits were good, I had a couple that were not so good. I was made to feel so bad about them in supervision that I cried in front of my manager. I felt completely unsupported. I wasn’t alone. Colleagues in my team had similar experiences and also talked of having cried in supervision.
I tried various strategies. I went part time (four days per week) to try and regain some control over my life. Yet I was still given a caseload of 30 cases, which was inevitably dangerous and unmanageable practice, given the complexity of the cases. I ended up working above and beyond my part time hours, working well over full-time, but getting paid a part-time rate.
I asked for a referral to occupational health, but my manager ignored the advice from them and continued to allocate work to me in the same way as before. I asked for a secondment to a different team but this was denied.
At my lowest point I did have fleeting thoughts of suicide
The union wanted to get involved but I didn’t want to rock the boat and I felt frightened and isolated. I really wish I had now. I probably should have taken time off sick but I felt too awful about the increased pressure it would put on other members of the team. I’m not going to deny that at my lowest point I did have fleeting thoughts of suicide.
I did not exist
I left the department emotionally exhausted, my confidence in tatters and disillusioned about social work as a profession. No one spoke to me to find out why I was leaving. It felt like I did not exist. It has only been the love and support of my family that has helped me recover.
To some extent I feel that I have been forced out of a job that I once loved because of poor management.
I really hope this empowers other social workers to speak up if they are suffering similar problems. We are good at speaking up for our service users but we very rarely do it for ourselves – yet if we don’t how will change ever occur?”
*names have been changed
You can stop burnout if you’re brave enough
*Kate a former hospital social worker outlines how her team turned around a high risk situation.
“The hospital social work team had been working at full stretch for some time. Demand for care plans and packages for older and disabled people was increasing, resources were reducing, senior management were concerned about delayed discharge and relationships between hospital staff and social care were poor at all levels.
Social workers and social care workers spent most of their time arguing about patient discharges and delays and chasing resources. The hospital expected swift action but patients and their families found this haste confusing and almost indecent.
As the team manager I found the bullying attitude of senior management from both the NHS and social services unbearable and it was becoming increasingly difficult to shield the team from it.
The final straw came when some members of the team were signed off long-term sick and two of the most experienced members announced they were seeking new jobs where they might actually be able to engage in social work.
Several team members were reduced to tears
Burnout was a real possibility
Morale plummeted. In supervision several team members were reduced to tears and professed themselves unable to continue with the relentless workload.
The sight of committed, able people in this state was distressing. Losing staff to burnout and stress was a real possibility. It became clear the situation had to be addressed.
Time to take action
I was careful to keep and gather accurate statistics. These showed the huge increase in workload and decrease in available resources (not least team members).
I used this information in three ways:
- Defending the team against accusations of not working hard or smart enough to avoid delayed discharges
- To make the case for temporary staff to fill in when others were off
- To argue for an increase in staffing
I also decided to take action against a particular member of senior management whose conduct amounted to bullying.
The team signed a letter to the director expressing concern about this person’s behaviour and asking for it to be addressed before it reached the point of a grievance. We were offered an alternative line of management.
Health and safety
I checked information on stress in the workplace on the Health and Safety Executive’s (HSE) website and asked the local authority’s health and safety team to assess the hospital team using the HSE template.
The team’s greatest asset was the support and care members showed for each other
This was done and the assessors said they were shocked at what they had found. Much of their concern may have been based on the danger of being found liable if people’s health actually collapsed, but this also helped get additional staff.
Another factor which improved matters was a positive effort to improve relationships with the hospital staff involved in discharge.
More could have been done, but when morale is low it is hard to muster the energy to get out of the situation.
Good management and strong peer support are key in dealing with stress and burnout. The team’s greatest asset was the support and care members showed for each other to get through this difficult period.
*names have been changed
Would you like more information?
If you would like a copy of our free Inform guide on Developing Emotional Resilience or more information about social worker burnout go to our Stand Up for Social Work campaign page.
The following trailer is for a film called Portraits of Professional Caregivers: their passion, their pain, which details the impact of compassion fatigue on professionals in America. If you would like more information on the film, or to arrange a UK screening, go to their website or facebook page.
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