Regular reflective discussion groups show “signs of promise” in boosting the wellbeing of children’s social workers at low cost, a trial has found.
The What Works for Children’s Social Care (WWCSC) funded study found that most children’s social workers from the 10 councils who took part in Schwartz Rounds, a series of collaborative discussion groups, reported a positive impact on their wellbeing and relationships with colleagues.
They also reported slightly lower psychological distress and took slightly fewer sickness absence days than those in a control group, but the difference was not statistically significant, found the research, carried out by WWCSC’s research partner, the Cardiff University-based CASCADE.
Reporting the results from one of its first trials, researchers found that Schwartz Rounds were “relatively low-cost” for councils to deliver, with initial set-up costs ranging from £5,204.75 and £6,505.14, and running costs per session ranging from £288.24 to £2,711.60, the majority of which were the indirect costs of staff time for those who attended.
Greater wellbeing
Schwartz Rounds involve a small group of staff members sharing stories based on their experiences, linked to a common theme such as “a child or family I will never forget”, in front of co-workers, who then share their own experiences.
Organisations such as hospital trusts, hospices, universities, dentists and veterinary practices currently use the approach, but it is not currently used widely in children’s services.
The first phase of the project, which involved six local authorities, was carried out in person. It was then put on pause, from March to September 2020, before resuming on a virtual basis for Covid-related reasons in phase two, which involved a further four councils. Overall, 776 staff were recruited to the study, split between those who took part in Schwartz Rounds and a control group. All of them responded to a survey before the trial, while 267 participants completed a survey after the trial.
The aim was for each council to provide six sessions, but in practice some provided only three, four or five.
The study found that staff who took part in the Schwartz Rounds had lower average General Health Questionnaire (GHQ-12) scores compared with the control group (12.9 compared with 13.5), indicating greater wellbeing.
It also found that staff who had taken part in Schwartz Rounds took on average 4.56 sickness absence days in the previous six months compared to 4.63 for those in the control group.
But the study concluded that neither of these differences were statistically significant.
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‘Normalising difficult emotional responses’
The research team also asked staff to complete feedback forms after each session, interviewed participants throughout the study, held focus groups with staff, and observed at least one session in each authority.
It said the feedback from staff who took part in both online and in-person Schwartz Rounds was “almost universally positive”.
It found 87.5% of staff that completed feedback forms following a session rated Schwartz Rounds as “good” or better, while more than 79% said the sessions had a positive effect on their psychological wellbeing and relationships with colleagues. Meanwhile, 57% said the sessions helped their direct work with families.
The research report said many staff commented on feedback forms that the sessions helped to “normalise difficult emotional responses” but some reported “feeling worse than before”.
It said workers also said the sessions improved awareness of different roles, prompted more supportive behaviour and increased organisational recognition.
‘Staff feel connected’
Kate Wells, principal child and family social worker at Leicester council, which took part in the survey, said Schwartz Rounds had helped colleagues to share their everyday feelings and experiences in their roles.
“People have left sessions feeling connected, re-energised and heard. It is really important that we have been able to offer this to our workforce,” she said.
“Since the end of the pilot we have trained more facilitators and rolled the rounds out across children’s social care and early help.”
WWCSC chief executive Michael Sanders said the results were encouraging and that he hoped Schwartz Rounds could “bring real benefits to social care staff in the future”.
On the back of the trial, the research report said that councils should consider introducing Schwartz Rounds and made 10 recommendations for how they should do so, including that authorities:
- Have enough trained facilitators and ensure Schwartz Rounds are actively supported by senior managers and have sufficient administrative support.
- Deliver the groups in person, with virtual groups introduced later when Schwartz Rounds are established.
- Make attendance optional, inform staff of what to expect before each session so they can decide whether to participate and make reasonable adjustments to ensure they are open and inclusive.
- Collect feedback from staff to inform the future development of Schwartz Rounds.
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Sorry to be mean spirited but in every single What Works study they fail to identify ‘what works’. From their prior ‘free coffee’ study to this one and others; All of them seem to offer vague findings such as more research is needed, and ‘we cannot draw firm conclusions from this’ etc etc
As a local authority the studies do not offer the confidence that a cash strapped council director should spend say £50k on the free coffee or on the Schwartz Rounds as it is far from clear if this would actually work aka definitely improve outcomes for children and families.
Whilst they are good intentioned abd certainly suggest that such activities are worthwhile. Schwartz rounds abd coffee are a great idea. They would be the icing on the cake if the government government tackle the underlying issues of long hours and heavy caseloads.
Any human being would benefit from sharing experience in a supportive group, listening to others doing similar work, being validated & recognised & understood & appreciated.
At first I thought the breathless reporting some sort of joke & then wondered how much time & money had been spent on this excursion into the obvious.
I am a registered social worker and a mentor for Schwartz Rounds. In this role I have worked for several years with NHS Trusts and hospices that have implemented Schwartz Rounds, as well as some of the Children’s Services pilot sites. Based on this experience I would strongly endorse the recommendations of this report.
There was a large scale research evaluation of Schwartz Rounds done by the National Institute for Health Research (Maben J, Taylor C, Dawson J, Leamy M, McCarthy I, Reynolds E, et al. A realist informed mixed methods evaluation of Schwartz Center Rounds® in England. Health Serv Deliv Res 2018;6(37) ). This produced some statistically significant findings, including reduced sickness absences, although many of the benefits of Schwartz Rounds intrinsically resist quantification. The NIHR report provides a detailed, evidence based analyis of the mechanisms that make Schwartz Rounds effective.
And then we went back to our poorly ventilated offices to attempt some meaningful work on our unmanageable workloads without the needed resources. Time out isn’t the same as time away from. Starbucks give me free coffee but I wouldn’t want to work for them.
If many of the benefits of Schwartz Rounds intrinsically resist quantification, that’s just saying the moon is made up of soft cheese and expecting us to accept it’s true on trust. If evidence matters, presumed efficacy is nonsense. Actually there are no statistically significant findings about benefits because the available data, from very small samples is too inconsequential for predictive causality. Or put another way, “we need further research”.
I prefer the Free Conversation Movement approach, a chair, a person, no financial cost and perhaps ( pre-covid) a hug. Some might miss the self reverential jargon mind.
Sitting on a bus. Group of school kids consoling one who is upset. Miss stop to listen on. Tears and raucous noise filled with profanities and genuine empathy. Almost joined in. Isn’t human interaction grand.
For me maybe do something radical and actually ask each employee what helps with their wellbeing. Maybe we should be creating a kind of social care assessment for each employee with strengths, weaknesses, likes, dislikes, needs at work, environment work best in, management style prefer etc. Some people may enjoy reflecting in a group, however other may not find this helpful and it may decrease wellbeing. For example, introverts, neurodivent people, people with social anxiety. It’s too much of a one size fits all and we’re putting on this weekly activity to help wellbeing but not actually asking if it does help… it doesnt make sense! It’s very geared towards the extroverted work who is likely to be more comfortable in larger groups.
It’s not real until a “clinical” psychologists says it’s real.