By Dr Sonya Wallbank, clinical director, The Arden Centre
Stress often seems to be almost par for the course in social work. A 2014 guide to stress management for NHS employers echoed previous editions of this guidance in citing findings by the Health and Safety Executive that workers in health and social care have ‘some of the highest rates of self-reported illness due to stress, anxiety and depression’ across all sectors.
The problem shows no signs of abating. In 2015, 97% of 2,000 respondents to a Community Care survey said they felt moderately or very stressed. And 80% of them believed their stress levels were affecting their ability to do the job.
Yet we don’t have to accept dangerous levels of stress as inevitable. Even for those who are perilously close to burnout there are ways to turn the situation around. Understanding the role of compassion satisfaction – that is, the pleasure you gain from doing your job – is key.
Building this into what I’ve called a ‘restorative model’ of clinical supervision has been evidenced to have a positive impact on stress and burnout. This model is now being used in an integrated way across a number of health and social care workforces.
A different model
Sonya Wallbank and professionals from Nottingham who have implemented the restorative supervision model will be speaking at Community Care Live about how the model works in practice, the benefits and challenges and improvements for practitioners and service users.
I first developed the restorative model of clinical supervision in 2007 when I was based with midwives, doctors and nurses working in obstetric and gynaecology settings. The pilot programme was designed to address the emotional demands on staff working in these areas and support them to build resilience that would reduce their stress and burnout levels.
The results showed restorative supervision increased compassion satisfaction – and therefore participants were finding their work more fulfilling – as well as reducing burnout and stress by over 40%.
One of the interesting findings was that, for some professionals, the pilot was the first opportunity since qualifying to think about the emotional demands of their role. The qualitative feedback from the pilot described the positive impact on patient care this had. When staff took the time to think and reflect, it made them better at caring for their patients.
Since the initial pilot programme, over 4000 professionals from across the UK and further afield have been trained in the approach.
Individual focus
The model is underpinned by a focus on the individual, their experiences and personal approach to their work. Where appropriate, supportively challenging their ways of working can make a significant, positive impact on their capacity to cope with stresses that arise. This supportive focus enhances resilience to manage the anxiety that day-to-day frontline work raises and helps them to think more clearly and work more effectively.
It is significantly different to other models of clinical supervision. Whereas many models use caseload as the starting point, this one places the emphasis on the individual staff member and how they interact with their caseload and workplace environment.
Social workers are always part of a system and organisational culture which can have a significant impact on them as an individual and how they approach work. This has been highlighted by serious case reviews that describe competent, well trained professionals who appear to have demonstrated a reduced capacity to reflect on and analyse what they see and make appropriate decisions.
By helping the individual to better understand themselves and their resilience, they gain insight into how their approach and specific development needs interact with the organisation. They gain a more personal understanding of what their service needs from them to create a balanced and resilient workplace. It is a win-win situation in which not only do the individual and organisation benefit, the vulnerable people they work with get better support.
This approach represents an important development in professional social work supervision, and also reflects a key theme of my current PhD research study. Although this research involves investigating the current social work supervision in Wales, I think there are significant connections between the restorative approach described here and the development of person centred practice as required by the Social Services and Wellbeing Act, due to come into effect next Wednesday, 6th April.
The focus of the research study is to investigate current supervisory practice in Adult social service departments. Initial findings support the idea that supervision for many individuals focuses on the “throughput” of cases, departmental targets and performance indicators. The idea of person centred practice, individualised outcomes for both service users and professionals is sadly the exception, rather than the norm. One key factor that has begun to emerge, is the skills and values of the first line manager/ supervisor in mediating between professional values and organisational priorities and demands.
There is however an opportunity, using models such as restorative practice, for supervision to be re-framed; particularly if collaborations between professionals and individual service users can be extended and brought into the supervisory conversation,enriching social work practice.
A further dimension of my research, is the extent to which citizen’s experience of Social Services’ intervention, can shape and enrich social work practice and their contribution to professional supervision.
I would hope that initiatives such as the restorative model , research studies such as mine and the increased focus on professional social work values,will ultimately lead to a more collaborative, person centred and co-productive version professional social work supervision.
However, there is an opportunity for professional supervisory practice to be re-framed into