How often do you experience guilt at not being able to meet people's needs due to factors beyond your control?
- Very often (74%, 405 Votes)
- Sometimes (19%, 104 Votes)
- Not at all as it's out of my control. (4%, 24 Votes)
- Rarely (2%, 11 Votes)
Total Voters: 544
Loading ...During my assessed and supported year in employment (ASYE), I was struck by how consistently ‘improving emotional resilience’ came up as a personal development goal.
Social work is known for being a demanding profession, requiring a great deal of emotional intelligence. The potential for vicarious trauma from supporting adults in extreme distress was something I was prepared for during the specialist mental health social work training scheme I undertook.
What I felt ill-prepared for was the unspoken need to balance the needs of the adults I support with those of the under-resourced organisation that employs me, which have frequently clashed.
Feeling conflicted
I found myself conflicted by the dual responsibility to deliver care and support tailored to each person’s circumstances, whilst managing a continually growing waiting list that was becoming unmanageable.
This tension has been particularly acute in my work with adults experiencing hoarding and self-neglect. This has provided some of the most enjoyable and rewarding experiences of my first year in practice – but also significant anxiety.
Research is clear that gradual, long-term, creative relationship-building is vital to securing sustainable outcomes for this group of adults, who frequently struggle to engage with services or reject support (Barnett, 2018).
Deficits in self-neglect practice
Such research also notes that this approach is still insufficiently practised; what you get instead are short-term, risk-averse and often traumatising interventions, such as ‘blitz cleans’.
Insufficient use of mental capacity legislation, including applications to the Court of Protection, is one of the most commonly noted practice deficits in self-neglect cases (Local Government Association, 2020).
Consequently, adults who may lack capacity to make decisions regarding their hoarding or self-neglect and who are at significant risk of harm have been erroneously discharged from services due to ‘non-engagement’ (Preston-Shoot & Braye, 2017).
In my experience, this stems from a stark inability for current statutory services to provide the long-term, time and resource-intensive work that is needed for many adults experiencing these difficulties.
Facing resistance from management
This can be seen at the statutory mental health service I work for, where waiting times reach up to 15 months.
When attempting to complete assertive outreach work with an adult who had experienced longstanding self-neglect and was both very averse to support and at high risk of harm, I experienced resistance from management.
This involved conversations about how the time taken working with this adult could have been spent supporting many more service users who “wanted to engage”.
Second-guessing yourself
Consequently, when making a lengthy application to the Court of Protection for another adult who lacked capacity to maintain her home safely due to hoarding, I found myself repeatedly second-guessing the need for such a time-intensive intervention.
I started to wonder whether I was erroneously prioritising individual interventions over offering support to the greatest number of people possible.
I doubt I am alone in feeling pressure to close cases early because of my caseload.
A recipe for burnout
What resulted throughout my ASYE year was an undercurrent of anxiety, low confidence in my own decisions and poor satisfaction with the work I was achieving – a perfect recipe for burnout.
Guidance from supervisors when I reflected on this anxiety was that I was internalising a service level pressure that was above my responsibility to manage: hence, the consistent drive to improve my resilience.
Yet, such a focus on individual resilience has been criticised as a neoliberal transference of responsibility from organisations to social workers (Garrett, 2015).
In other words, the burden often falls on practitioners to respond to circumstances in need of wider system change, rather than on organisations to make these changes.
I struggle to understand how social workers can communicate this state of affairs to those they support. When ending work with at-risk adults early, how do we ensure that is not perceived as them not struggling ‘enough’ for services to support them?
‘Good enough’ social work
How do we make clear the impact of limited resources on the extent of support we offer, without transferring the overwhelm we feel as a service and thereby eroding a sense of safety within public services?
Donald Winnicott (1953) spoke about ‘good enough’ parenting as a sustainable alternative to striving to provide a perfect, and impossible, experience of childhood. Pursuing ‘good enough’ social work – practising in the best means possible within the constraints of resources available – offers a coping strategy for practitioners.
But this only goes so far.
What is desperately needed is systemic change, backed up by the increased resources for statutory services that so many have demanded, over so many years, to no avail.
What I fear will continue to happen without this is that more practitioners will burn out and ‘vote with their feet’, exacerbating staff shortages and deepening the crisis in our services.
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Social work is just crisis management now. We support people short term to complete the assessments, paperwork, offer a package of care, and move on to the next one. I have often wondered why we are taught relationship based social work etc in uni and then in the workplace asked to complete everything in as little visits as possible. Social work has become care management, not social work.
But I find it hard to blame managers on this, when they are under the most pressure they’ve ever had to address the longest waiting lists we’ve ever had. Exactly how are they supposed to address that? Not possible without wider investment and funding to bring in significantly more social workers. (Which is the opposite of what is happening now – social work duties going to unqualified workers to cover the lack of social workers!)
This social worker is completely right in everything she says. She should also take meassures to protect herself – when lack of resources could mean a service user is in danger or could put others in danger, this should be flagged up. As an individual it is hard to argue for more resources; it is important that we join together in Union or Professional Association to push for change.
The issues highlighted start from the very top. The government have consistently underfunded social work right across the board. Every service struggles to offer a good service whilst juggling which case can be closed or moved on to another team or service. Families left to wait for a social worker to begin assessments and then another wait for a service to be implemented. Sometimes some extremely risky decisions are having to be made to try to balance the need against the lack of services.
Until the government agree to adequately fund social work there will always be a short fall of social work practioners. Therefore high case loads and possibly a low standard of intervention. Everyone involved with the care services need to work together to support each other and to make their local MP’s take this urgent matter to the people in power.
I have experienced burn out and I not worked for two years. I feel I have had no support. This was impacted by guilt and a sense of powerlessness in face of mounting work loads. There is no compassion and there is no support in social work as a profession.
The issues highlighted start from the very top. The government have consistently underfunded social work right across the board. Every service struggles to offer a good service whilst juggling which case can be closed or moved on to another team or service. Families left to wait for a social worker to begin assessments and then another wait for a service to be implemented. Sometimes some extremely risky decisions are having to be made to try to balance the need against the lack of services.
Until the government agree to adequately fund social work there will always be a short fall of social work practioners. Therefore high case loads and possibly a low standard of intervention. Everyone involved with the care services need to work together to support each other and to make their local MP’s take this urgent matter to the people in power.
Why are we not recruiting a cohort of permanent staff. If it’s money we need then it is wasted on locum staff who are not invested in a Team. That money could be used on more services for venerable clients.
Furthermore social workers should be protected from burnout… get rid of inexperienced managers. The whole system
Needs a shake up!
I felt so “guilty” that I decided to leave the profession to seek pastures new. Not been easy but living with “guilt” as a part of your daily work culture is deeply unhealthy (understatement). By the way, if you’re waiting on a government of whatever political hue to improve things, well don’t hold your breath.
Left the profession, working in the aviation sector nowe and loving it
Self preservation is not a crime
This isn’t just a social work problem – having worked in social care, schools and health related areas for the past decade I have seen the impact (as I am sure everyone has) in all areas.
There is a veneer of policy, guidance, law and narrative which suggests that the science, the evidence base, the best practice is valued, understood and adopted but behind that façade is a chasm where there should be actual resources to deliver these noble aims!
Our public services have been hollowed out and we are inside shouting into the void.
Individual works on the ground are invariably left carrying the cognitive dissonance. The mental and emotional load in unbearable.
I have been advised by my manager “not to think about it”…. top notch advice and support right there.
Structural overhaul is needed or maybe I need to go and work in retail.