Measuring stress in child protection

["Anne E. HOLLOWS\(HSC\)" <A.E.Hollows@xxxxxxxxx>]

I have just completed a qualitative study of the ways in which social workers
make clinical judgements and have found the list's discussion on different
perspectives on stress, and latterly the discussion of potential to change,
intriguing. 

 I have found it helpful to separate distress (which may itself contribute to
stress) from stress itself. The work in child welfare inevitably creates
distress and sadness in workers, but the mechanisms whereby distress operates
are not necessarily the same as the mechanisms whereby stress affects practice.
Distress, along with other personal experiences, affects mood - and may also
link with anticipatory regret.  There may be a number of effects and, for me,
they have been most graphically described by Janis and Mann (1977) in their
conflict theory of decision making. To read their accounts of unconflicted
change, unconflicted adherence, defensive avoidance, or hypervigilance, is to
recognise only too clearly the ways in which stress that goes unrecognised or
unmanaged may contribute to judgements and decisions about children being
compromised widely, as well as providing some insights as to why workers find
it so difficult to help themselves. 

(A detailed review of the literature on judgements under stress is presented in
the book of the same name by Kenneth Hammond (OUP, 2000) for those with a
particular interest in the judgement side).

My own study suggests that the problem may be as great for managers/practice
supervisors, however, as they are increasingly pressured to deliver superficial
targets from above, while attempting to maintain the vestiges of the
supervisory tradition within social work. The stressed manager is just as
likely to demonstrate unconflicted adherence as the practitioner - and as
Steven Brookfield has noted, it is hard to achieve critical thinking as an
individual when one is being taught, or managed, by someone who cannot think
critically.

The issues here seem to be both at a structural level - contextual issues
including agency pressures, government pressures to deliver, shortage of staff,
deficits in training and supervision - and at a personal level, which resonates
with the comments on resilience.The coincidence of individual vulnerability and
adverse context creates the worst outcomes for children as we know, and similar
patterns operate for workers.
 I found Mark Horwitz's paper (made available on this last last year)
particular helpful in echoing some of my own findings in this area.

Child protection and much of the child welfare task is a job that involves
tough and sometimes painful decisions, which must be grounded in evidence, both
from research in general and from the particular case in question. That does
not mean the research evidence has to be followed blindly, but it does mean
there should be a clear articulation of the reasons for doing something
different. There is an important issue here about authenticity both in
individual practice and at every level of an agency's processes. My study
suugests that those who had embraced the concept of authenticity were better
able to manage the distress, and to defend themselves, very credibly, against
organisational aspects of stress (e.g. taking on their managers).

The problem with the veiwpoint that 'we know all this already' is the tendency
to assume that someone is doing something about it - or indeed that they know
what to do. Keeping studying the issue reveals, depressingly, that there are
few contructive endeavours in the area. It has been salutory for me to meet
former students with two or three years practice experience returning to study
on post qualifying courses with graphic accounts of the impact of the work on
their mental and physical health. I do not believe that is has to 'go with the
territory' . It also seems to be a phenomenon that is common across national
bundaries. Perhaps we should be looking for some means of compiling the
research  in a coherent form that could move the debate on and develop a
serious response. 



Anne Hollows
Principal Lecturer in Social Work
School of Health and Community Studies
Sheffield Hallam University
Collegiate Crescent Campus
Sheffield S10 2BA

tel  +44 (0) 114 225 2369
fax+44 (0) 114 225 2430