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Twis MK, Cimino AN, Plunk M. Beyond Victim Identification: A Practitioner's Guide to Designing a Youth Anti-Sex Trafficking Advocacy Program. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:548-560. [PMID: 38916471 DOI: 10.1080/19371918.2024.2370782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Thousands of youth are sexually trafficked each year in the United States. In order to address this concern, anti-trafficking advocates often emphasize the importance of uniform screening protocols to assist with the identification of survivors. Unfortunately, an oft-overlooked component of sex trafficking identification is what to do once a victim has been identified, and how to best meet survivors' complex needs. In this article, the authors provide social work practitioners and other advocates with best practice guidelines for how to design and evaluate anti-sex trafficking advocacy programs for children and youth. These guidelines include considerations related to direct services with clients, community partnerships, and organizational capacity, as well as recommendations for how to begin and then evaluate programming. Regardless of the form selected for the program, all anti-sex trafficking programs should be designed to provide effective, client-centered follow-up and advocacy once a positive identification is made in the community. The recommendations included in this paper are based upon extant literature, the authors' practice experience with survivors, and insights from anti-sex trafficking program evaluations.
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Affiliation(s)
- Mary K Twis
- Department of Social Work, Texas Christian University, Fort Worth, Texas, USA
| | - Andrea N Cimino
- Johns Hopkins School of Nursing, Danger Assessment Training & Technical Assistance Center, Baltimore, MD, USA
| | - Marilyn Plunk
- Department of Social Work, Texas Christian University, Fort Worth, Texas, USA
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Luo M, Hou H, Jiang Y, Li J, Li S, Xia Z. Emergency nurses' experience in caring for unidentified patients: A qualitative study. Int Emerg Nurs 2024; 74:101455. [PMID: 38677060 DOI: 10.1016/j.ienj.2024.101455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/21/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To describe and analyse emergency nurses' experiences of caring for unidentified patients, and to provide a basis for constructing processes and standards of care for unidentified patients in the emergency department. METHODS This study is a descriptive phenomenological research that utilized purposive sampling. Sixteen emergency department nurses, who cared for unidentified patients between June and September 2023, were selected for semi-structured face-to-face interviews. Data were analyzed using Colaizzi's 7-step method to identify and refine themes. RESULTS Three themes were distilled: (1) increased workload, (2) increased mental stress at work, and (3) material needs and external environmental support. CONCLUSION Emergency nurses have more complex negative emotional experiences when dealing with unidentified patients and want more external support to cope with such patients. Hospital administrators should pay full attention to nurses' caregiving experiences and provide positive interventions.
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Affiliation(s)
- Mingmin Luo
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
| | - Hailong Hou
- School of Nursing, China Medical University, NO.77 Puhe Street, Shenyang 110122, Liaoning, PR China
| | - Yan Jiang
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China.
| | - Jin Li
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
| | - Shuang Li
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
| | - Zhijun Xia
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
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Ward RJ, Greenway FT, Maguire N. 'It Is Good to See the Person As a Whole Person and… Continue to Improve Our Psychologically Informed Working': A Thematic Analysis of Clinical Psychology Trainee Placements in Homelessness Settings. Health Expect 2024; 27:e14121. [PMID: 38923088 PMCID: PMC11194176 DOI: 10.1111/hex.14121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/02/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVES The National Framework for Inclusion Health identified the need for collaborative action between the NHS and third sector health to improve access and outcomes for Inclusion Health groups. Clinical psychology trainee placements in homelessness settings could be a valuable pathway to improving access to psychological support for people experiencing homelessness and the provision of clinical services, which is key to developing the workforce and a catalyst for the future recruitment of clinical psychologists in the third sector. METHODS A qualitative evaluation was conducted using semistructured interviews to explore the perspectives of clinical psychology trainees, supervisors, staff in homelessness settings and a peer mentor. Twenty-two participants were recruited from two universities and six services across the South East, including 11 clinical psychology trainees, six supervisors, four placement staff and one peer mentor. RESULTS Placement staff described the value of a psychological approach but identified some challenges to be overcome. Induction was identified as the key to success. Supervisors recognised the breadth and depth added to trainees' knowledge and skills alongside significant challenges. Trainees valued the opportunities to work in homelessness settings and develop their understanding of the role. The peer mentor identified collaborative working as especially important. CONCLUSIONS Clinical psychology trainee placements are a necessary programme to fulfil the NHS vision for Inclusion Health. These placements equip the health and social care workforce to create excellent and sustainable provisions to improve the physical and mental health of people experiencing homelessness whilst also providing much-needed psychological support for staff. PATIENT AND PUBLIC CONTRIBUTION Psychologically Informed Environments Through Staff Training: Staff training and support within these placements contribute to the development of psychologically informed environments. This not only leads to better outcomes for both staff and clients but also aligns with the objectives of the National Framework for Inclusion Health, fostering sustainable provision for the health needs of people experiencing homelessness (PEH). Enhanced Therapeutic Adaptability: Trainees gain invaluable experience in adapting therapy to meet the diverse needs of clients, benefiting both trainees and clients alike. This adaptability fosters more effective therapeutic relationships and contributes to the improvement of inclusion health provision in the long term. Tailored Therapy for Timely Intervention: Clinical psychology trainee placements in homelessness settings offer therapy that bypasses long waiting times for interventions, crucial for individuals experiencing homelessness. This flexible approach caters to the unpredictable engagement levels of PEH, ensuring timely support aligning with the Health and Care Act 2022 to improve overall health and address health disparities through primary care networks.
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Affiliation(s)
- Rebecca J. Ward
- Centre for Homelessness Research and PracticeUniversity of SouthamptonSouthamptonUK
| | - Frances T. Greenway
- Centre for Homelessness Research and PracticeUniversity of SouthamptonSouthamptonUK
| | - Nick Maguire
- Centre for Homelessness Research and PracticeUniversity of SouthamptonSouthamptonUK
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4
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Steenekamp BL, Barker SL. Exploring the Experiences of Compassion Fatigue Amongst Peer Support Workers in Homelessness Services. Community Ment Health J 2024; 60:772-783. [PMID: 38285087 PMCID: PMC11001661 DOI: 10.1007/s10597-024-01234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
Peer support workers have lived experiences of the challenges their clients face. While research has shown peer work can benefit recovery, the negative consequences have not been clearly addressed. This study aimed to explore the experiences of compassion fatigue amongst peer support workers in homelessness services, and the coping strategies used. An explorative qualitative design was adopted. Six peer support workers, in homelessness services, were recruited via snowball sampling. Data was collected using semi-structured interviews and analysed using thematic analysis. Five themes were identified: relentless nature of working in homelessness services, change, making meaning of past experiences, organisational support, and personal coping strategies. There were two novel findings: (1) multiple clients recounting traumatic experiences, and (2) being unfairly blamed for lack of progress, exacerbating compassion fatigue. The findings of this study furthers limited research on compassion fatigue and can be used to develop protocols and practices for organisations that utilise peer support.
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5
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Crole-Rees C, Kalebic N, Tomlin J, Forrester A. Can prisons be trauma-informed? Reflections on the development of a trauma-informed approach. J Forensic Leg Med 2023; 100:102609. [PMID: 37984320 DOI: 10.1016/j.jflm.2023.102609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/29/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Clare Crole-Rees
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK; Oxford Health NHS Foundation Trust, UK.
| | - Natasha Kalebic
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
| | - Jack Tomlin
- School of Law and Criminology, University of Greenwich, London, UK
| | - Andrew Forrester
- Forensic Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Haydn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
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Weldrick R, Canham SL, Sussman T, Walsh CA, Cormier É, Mahmood A. Delivering Services to Older Persons Experiencing Homelessness: Providers' Perspectives of What Does and Does Not Work. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:29-42. [PMID: 35678024 DOI: 10.1080/01634372.2022.2087128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
Older people with experiences of homelessness (OPEH) tend to experience more complex health, social, and psychological issues than people experiencing homelessness at younger ages. Simultaneously, many housing resources (e.g., shelters, temporary housing) are often ill equipped to meet the needs of OPEH. As such, OPEH are often unable to age in the right place (AIRP) - that is, in a place that supports unique needs and vulnerabilities. However, several promising practices exist that deliver housing and services tailored to OPEH. To investigate the aspects of housing and shelter that both promote and impede AIRP for OPEH, this study examines the delivery of services in three such promising practices from the perspective of service providers. Findings from fifteen qualitative interviews revealed three overarching themes: 1) barriers to providing individualized support (e.g., staff turnover); 2) shifting contexts and structures (e.g., housing market changes); and 3) mechanisms of success (e.g., facilitating smooth transitions into permanent housing). These findings provide evidence to support the refinement of service delivery to promote AIRP for OPEH. In doing so, these insights can help to elevate promising practices to the level of best practice.
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Affiliation(s)
- Rachel Weldrick
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Sarah L Canham
- College of Social Work, University of Utah, Salt Lake City, UT, USA
- College of Architecture and Planning, University of Utah, Salt Lake City, UT, USA
| | - Tamara Sussman
- School of Social Work, McGill University, Montreal, QC, Canada
| | | | | | - Atiya Mahmood
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
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Kerman N, Ecker J, Tiderington E, Aykanian A, Stergiopoulos V, Kidd SA. “Systems trauma”: A qualitative study of work-related distress among service providers to people experiencing homelessness in Canada. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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8
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Kerman N, Goodwin JM, Tiderington E, Ecker J, Stergiopoulos V, Kidd SA. Towards the Quadruple Aim in permanent supportive housing: A mixed methods study of workplace mental health among service providers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6674-e6688. [PMID: 36134703 DOI: 10.1111/hsc.14033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
The Quadruple Aim is a health policy framework with the objective of concurrently improving population health, enhancing the service experience, reducing costs and improving the work-life of service providers. Permanent supportive housing (PSH) is a best practice approach for stably housing people experiencing homelessness who have diverse support needs. Despite the intervention's strong evidence base, little is known about the work-life of PSH providers. This study explored the mental health and work challenges experienced by PSH providers in Canada. Using an explanatory sequential, equally weighted, mixed methods design, 130 PSH providers were surveyed, followed by semi-structured interviews with 18 providers. Quantitative findings showed that 23.1% of PSH providers had high psychological distress. Participants who were younger, spent all or almost all of their time in direct contact with service users and had less social support from coworkers were significantly more likely to have high psychological distress. Three themes were identified from the qualitative analysis that showed how PSH providers experience psychological distress from work-related challenges: (a) Sisyphean Endeavours: 'You Do What You Can', (b) Occupationally Unsupported: 'Everyone Is Stuck in Their Zone' and (c) Wear and Tear of 'Continuous Exposure to Crisis and Chaos'. The themes interacted with systemic (Sisyphean Endeavours) and organisational issues (Occupationally Unsupported), intensifying the emotional burden of day-to-day work, which involved frequent crises and uncertainty (Wear and Tear of 'Continuous Exposure to Crisis and Chaos'). The findings underscore how these challenges threaten providers' wellness at work and have implications for the care provided to service users. Accordingly, the Quadruple Aim is a potentially useful and applicable framework for measuring the performance of PSH programs, which warrants further consideration in research and policy.
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Affiliation(s)
- Nick Kerman
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jordan M Goodwin
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Emmy Tiderington
- School of Social Work, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| | - John Ecker
- Canadian Observatory on Homelessness, York University, Toronto, Ontario, Canada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sean A Kidd
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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9
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Zufferey Cz C, Skovdal Ms M, Gjødsbøl Img IM, Jervelund Ssj SS. Caring for people experiencing homelessness in times of crisis: Realities of essential service providers during the COVID-19 pandemic in Copenhagen, Denmark. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 79:103157. [PMID: 35845103 PMCID: PMC9273523 DOI: 10.1016/j.ijdrr.2022.103157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The COVID-19 pandemic shed light on rooted social inequalities and on housing as a crucial social determinant of health. Little is known on current practices and new opportunities to support people experiencing homelessness in a situation of a global health crisis. This study explores frontline workers' experiences of providing essential services to people experiencing homelessness in Copenhagen, Denmark, during the first COVID-19 lockdown, and highlights best practices of care in future crises. METHODS Semi-structured interviews were conducted in August-September 2020 with nine service providers working in six organizations offering essential services to people experiencing homelessness during the spring 2020 lockdown in Copenhagen. The data analysis, following inductive coding, drew upon the concept of disaster resilience. RESULTS Several initiatives were undertaken by the municipality and local organizations to ensure the continuation and adaptation of essential services to people experiencing homelessness during the COVID-19 crisis. These included collaborations with and financial support from businesses, the municipality, and other service providers; a mobile test unit, temporary shelters, and isolation sites; and an increased availability of opioid substitution treatment. Several improvements are to be made, particularly regarding sustainability and long-term benefits of the initiatives, facility-level risk preparedness, universal access to essential services for undocumented migrants, as well as collaboration between service providers. CONCLUSIONS The lockdown offered the opportunity to experiment with innovative ways of working, of which many had a protective effect on people experiencing homelessness. This knowledge can be used to improve services and reduce the long-term vulnerability of people experiencing homelessness.
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Affiliation(s)
- Chloé Zufferey Cz
- Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark
| | - Morten Skovdal Ms
- Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark
| | | | - Signe Smith Jervelund Ssj
- Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark
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10
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Aykanian A. The effects of COVID-19 on the mental health and job stress of frontline homelessness services workers in Texas (U.S.). HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2793-e2804. [PMID: 35037348 DOI: 10.1111/hsc.13723] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/03/2021] [Accepted: 12/31/2021] [Indexed: 06/14/2023]
Abstract
As the COVID-19 pandemic persists in the U.S. and elsewhere, there is a growing need to understand the impacts of the pandemic on essential and frontline workers. Given the dearth of research on the experiences of homelessness services workers during the COVID-19 pandemic, this study aimed to understand the impact of COVID-related stressors in the workplace on the wellbeing of the homelessness services workers in the state of Texas (U.S.). Using a cross-sectional survey design, the analysis focusses on examining the relationship between COVID stressors with mental health symptoms and job stress indictors. Data were collected from a sample of 132 frontline homelessness services workers across the state during April, May and June of 2021. Primary outcomes of interest were measured with the Depression, Anxiety and Stress Scale (DASS-42) and the Professional Quality of Life Scale (ProQOL). Multiple linear regression models were specified to explore associations between the outcomes of interest and predictor variables (i.e. demographics, work experiences and COVID-19 stressors). Results showed that perceiving a decline in job satisfaction because of the COVID-19 pandemic was associated with higher stress (β = ++0.18), 95% CI [.13, 6.68], higher burnout (β = 0.32), 95% CI [2.54, 7.30] and lower compassion satisfaction (β = 0.42), 95% CI [-8.14, -3.69]. Additionally, being worried about contracting COVID-19 at work was associated with an increase in burnout (β = 0.19), 95% CI [.40, 4.79]. Also notable is that older age and Black/African American race were associated with lower stress, lower burnout and higher compassion satisfaction. Implications for supporting the homelessness sector through high-quality supervision, useful training, adequate benefits and routine check-ins are discussed.
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Affiliation(s)
- Amanda Aykanian
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
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11
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Kerman N, Ecker J, Gaetz S, Tiderington E, A. Kidd S. Mental Health and Wellness of Service Providers Working with People Experiencing Homelessness in Canada: A National Survey from the Second Wave of the COVID-19 Pandemic. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:371-379. [PMID: 34013774 PMCID: PMC9065493 DOI: 10.1177/07067437211018782] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This study examined the scope of common mental health problems and perceived impacts of the COVID-19 pandemic among direct service providers working with people experiencing homelessness in Canada. METHOD This cross-sectional study used an online survey that was disseminated to homeless service, supportive housing, and harm reduction organizations and networks. Data were collected on depression, anxiety, stress, post-traumatic stress, compassion satisfaction and fatigue, and substance use problems as well as pandemic-related changes in mental health and wellness. A total of 701 service providers completed the survey and were included in data analysis. Descriptive statistics were used to examine the primary research questions, with hierarchical multiple regression models also being fit to explore mental health and wellness differences by occupational service setting. RESULTS Most direct service providers (79.5%) working with people experiencing homelessness reported a decline in their mental health during the pandemic. There were high rates of common mental health problems within the sample that are largely consistent with those found among health-care workers during the pandemic. Occupational service settings were not associated with the severity of mental health problems, indicating pervasive issues across the workforce, though providers who were younger and spent more time in direct service roles were at greater risk. CONCLUSIONS The common mental health problems and negative impacts of the pandemic among service providers working with people experiencing homelessness highlight a highly vulnerable workforce that could benefit from improved access to supports. Given the similarities between our findings and other studies examining essential workforces, it is recommended that initiatives that provide accessible mental health care to the health-care workforce during the pandemic be expanded to include homeless and social service providers.
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Affiliation(s)
- Nick Kerman
- The Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John Ecker
- Canadian Observatory on Homelessness, York University, Toronto, Ontario, Canada
| | - Stephen Gaetz
- Faculty of Education, York University, Toronto, Ontario, Canada
| | - Emmy Tiderington
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Sean A. Kidd
- Department of Psychiatry, University of Toronto, Ontario, Canada
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Schneider C, Hobson CW, Shelton KH. 'Grounding a PIE in the sky': Laying empirical foundations for a psychologically informed environment (PIE) to enhance well-being and practice in a homeless organisation. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e657-e667. [PMID: 34057251 DOI: 10.1111/hsc.13435] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/16/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
While psychologically informed environments (PIEs) are gaining in prominence in efforts to improve well-being and practice in the homeless sector, their empirical foundations remain tenuous. We present a unique scoping needs analysis of staff and client well-being, staff attitudes and the social-therapeutic climate in a UK-based homeless prevention organisation (prior to PIE implementation). Our aims were: (a) to apply a robust framework to pinpoint need and target forthcoming PIE initiatives and (b) to establish a validated needs baseline that informs and measures efficacy of PIE for its future development. Four established personal and practice well-being measures were administered to 134 (predominantly 'frontline') staff and 50 clients. Staff completed the: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), Professional Quality of Life Scale (measuring compassion satisfaction [CS], burnout [BO] and secondary traumatic stress [STS]), Attitudes related to Trauma-informed Care Scale (ARTIC-10; measuring practice attitudes towards trauma-informed values) and the Essen Climate Evaluation Schema (EssenCES; measuring perceptions of client cohesion, safety and practitioner relationships in housing projects). Clients completed the WEMWBS and EssenCES. Vulnerability to STS was evident in nearly two-thirds of frontline staff and it was a statistically significant predictor of BO. It was not, however, associated with lesser levels of CS. We discuss this complex dynamic in relation to highlighted strategic recommendations for the PIE framework, and the identified potential challenges in implementing trauma-informed and reflective practice in the organisation. We conclude with a critique of the value and the lessons learnt from our efforts to integrate stronger empirical substance into the PIE approach.
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13
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Zheng G, Lyu X, Pan L, Chen A. The role conflict-burnout-depression link among Chinese female health care and social service providers: the moderating effect of marriage and motherhood. BMC Public Health 2022; 22:230. [PMID: 35120482 PMCID: PMC8815119 DOI: 10.1186/s12889-022-12641-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Women with depression disorder outnumber men, and health care and social service providers are mostly female. Drawing on conservation of resources (COR) theory, this study aims to examine the association between role conflicts and depression among health care and social service providers, and further investigate the mediating effect of burnout, as well as the moderating effect of marital status and motherhood. Methods The data come from the baseline of the ‘China Social Work Longitudinal Study’ conducted in 2019, which contains 1,219 female social workers who reported work-family conflict. The five items of the scale in our model were extracted from the existing literature to ensure the construct validity of potential variables, and confirmatory factor analyses (CFAs) were also conducted to ensure the validity and reliability of the scale. Descriptive analyses and correlation analyses were performed with SPSS 24, while the path analysis was conducted using Amos 24. The moderating effects of marital status and motherhood were further tested using multiple-group analyses. Results Female health care and social service providers experienced a high level of depression. Work-to-family conflict (WFC), family-to-work conflict (FWC), and organizational role conflict (ORC) were significantly and positively associated with female social workers’ depression. Exhaustion and cynicism fully mediated the effects of ORC on depression and partially mediated the effects of WFC on depression. In addition, FWC had only a direct effect on depression. A multiple-group analysis further indicated that both marital status and motherhood status may have played a moderating role in the conflict-burnout-depression link and that being unmarried and having no child were risk factors for depression in female health care and social service providers. Conclusions Marriage and motherhood have both negative and positive effects on the depression of female health care and social service providers. This suggests that marriage and motherhood may act as a form of “family clientelism” for female health care and social service providers who marry and have children.
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Affiliation(s)
- Guanghuai Zheng
- Department of Social Work, Central China Normal University, NO.152 Luoyu Road, Wuhan, Hubei, 430079, P. R. China
| | - Xinshu Lyu
- Department of Social Work, Central China Normal University, NO.152 Luoyu Road, Wuhan, Hubei, 430079, P. R. China
| | - Li Pan
- School of Social Development and Public Policy, Beijing Normal University, Xinjiekouwai St, Haidian District, Beijing, 100875, P. R. China
| | - Anna Chen
- Department of Social Work, Central China Normal University, NO.152 Luoyu Road, Wuhan, Hubei, 430079, P. R. China.
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14
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Winnett R. The experiences of hospital social workers who care for homeless patients: an interpretive phenomenological analysis. SOCIAL WORK IN HEALTH CARE 2022; 61:52-68. [PMID: 35098903 DOI: 10.1080/00981389.2022.2033379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/07/2022] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
Unique challenges exist for hospital social workers tasked with the care of patients experiencing homelessness. These challenges affect patient care, impact social work practice, and emphasize the need to better understand the experience of providing services to this vulnerable population. Research is limited and focuses upon the experiences of unhoused patients and of medical management, not upon the experiences of the social workers positioned to meaningfully impact care. To address this gap, the current study utilized Interpretive Phenomenological Analysis (IPA) to examine the lived experiences of hospital social workers providing services to homeless patients. Respondents identified fulfilling aspects of this work but also emphasized the deeply personal and professional challenges it engendered. Recommendations were offered for supporting hospital social workers' self-care, incorporating effective practice perspectives, and providing meaningful patient support. Alignment of respondent experiences with literature on compassion satisfaction, compassion fatigue, work life conditions, and burnout was considered.
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Affiliation(s)
- Ren Winnett
- Doctorate of Social Work Program, School of Social Work, Rutgers the State University of New Jersey, USA
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15
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Kerman N, Ecker J, Tiderington E, Gaetz S, Kidd SA. Workplace trauma and chronic stressor exposure among direct service providers working with people experiencing homelessness. J Ment Health 2022; 32:424-433. [PMID: 34983295 DOI: 10.1080/09638237.2021.2022629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Service providers working with people experiencing homelessness can be directly and indirectly exposed to trauma and other chronic stressors in their work. The types of individuals that are most at-risk of problematic outcomes from traumatic event exposure are unknown. AIM This study examined exposure to and effects of workplace traumas and stressors among service providers working with people experiencing homelessness in Canada. METHODS A cross-sectional survey was completed by 701 direct service providers working in the homeless service, supportive housing, and harm reduction sectors. Descriptive statistics, hierarchical multiple regression, and double moderation models were used in the analysis. RESULTS Employment in homeless service settings, service provision to single adults, and more time in direct contact with service users were each positively associated with the frequency of exposure to critical events and chronic stressors. Younger age, lived experience of behavioural health problems, more frequent exposure to chronic stressors, and less social support from coworkers were significantly correlated with post-traumatic stress and general psychological distress. Emotional support from supervision moderated the relationship between direct exposure to workplace critical events and post-traumatic stress. CONCLUSIONS More trauma-informed psychosocial supports tailored to the needs of direct service providers working with people experiencing homelessness are needed.
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Affiliation(s)
- Nick Kerman
- Centre for Addiction and Mental Health, Toronto, Canada
| | - John Ecker
- Canadian Observatory on Homelessness, York University, Toronto, Canada
| | - Emmy Tiderington
- School of Social Work, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Stephen Gaetz
- Faculty of Education, York University, Toronto, Canada
| | - Sean A Kidd
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Lenzi M, Santinello M, Gaboardi M, Disperati F, Vieno A, Calcagnì A, Greenwood RM, Rogowska AM, Wolf JR, Loubière S, Beijer U, Bernad R, Vargas-Moniz MJ, Ornelas J, Spinnewijn F, Shinn M. Factors Associated with Providers' Work Engagement and Burnout in Homeless Services: A Cross-national Study. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:220-236. [PMID: 33137234 DOI: 10.1002/ajcp.12470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The complexity of homeless service users' characteristics and the contextual challenges faced by services can make the experience of working with people in homelessness stressful and can put providers' well-being at risk. In the current study, we investigated the association between service characteristics (i.e., the availability of training and supervision and the capability-fostering approach) and social service providers' work engagement and burnout. The study involved 497 social service providers working in homeless services in eight different European countries (62% women; mean age = 40.73, SD = 10.45) and was part of the Horizon 2020 European study "Homelessness as Unfairness (HOME_EU)." Using hierarchical linear modeling (HLM), findings showed that the availability of training and supervision were positively associated with providers' work engagement and negatively associated with burnout. However, results varied based on the perceived usefulness of the training and supervision provided within the service and the specific outcome considered. The most consistent finding was the association between the degree to which a service promotes users' capabilities and all the aspects of providers' well-being analyzed. Results are discussed in relation to their implications for how configuration of homeless services can promote social service providers' well-being and high-quality care.
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Affiliation(s)
- Michela Lenzi
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Massimo Santinello
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Marta Gaboardi
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Francesca Disperati
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | - Antonio Calcagnì
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
| | | | | | - Judith R Wolf
- Impuls-Netherlands Center for Social Care Research, Radboud Institute for Health Sciences, Radboud, The Netherlands
- University Medical Center, Nijmegen, The Netherlands
| | - Sandrine Loubière
- School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of life Center, Aix-Marseille University, Marseille, France
- Department of Research and Innovation, Support Unit for Clinical Research and Economic Evaluation, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - Ulla Beijer
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Maria J Vargas-Moniz
- APPsyCI-Applied Psychology Research Center Capabilities and Inclusion, ISPA-Instituto Universitário, Lisboa, Portugal
| | - José Ornelas
- APPsyCI-Applied Psychology Research Center Capabilities and Inclusion, ISPA-Instituto Universitário, Lisboa, Portugal
| | - Freek Spinnewijn
- FEANTSA, European Federation of National Organisations Working with the Homeless, Bruxelles, Belgique
| | - Marybeth Shinn
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, TN, USA
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Ruiz-Fernández MD, Ortiz-Amo R, Andina-Díaz E, Fernández-Medina IM, Hernández-Padilla JM, Fernández-Sola C, Ortega-Galán ÁM. Emotions, Feelings, and Experiences of Social Workers While Attending to Vulnerable Groups: A Qualitative Approach. Healthcare (Basel) 2021; 9:healthcare9010087. [PMID: 33477295 PMCID: PMC7830559 DOI: 10.3390/healthcare9010087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/26/2022] Open
Abstract
Social workers in the community setting are in constant contact with the suffering experienced by the most vulnerable individual. Social interventions are complex and affect social workers’ emotional well-being. The aim of this study was to identify the emotions, feelings, and experiences social workers have while attending to individuals in situations of vulnerability and hardship. A qualitative methodology based on hermeneutic phenomenology was used. Six interviews and two focus group sessions were conducted with social workers from the community social services and health services of the Andalusian Public Health System in the province of Almería (Spain). Atlas.ti 8.0 software was used for discourse analysis. The professionals highlighted the vulnerability of certain groups, such as the elderly and minors, people with serious mental problems, and people with scarce or no economic resources. Daily contact with situations of suffering generates a variety of feelings and emotions (anger, sadness, fear, concern). Therefore, more attention should be paid to working with the emotions of social workers who are exposed to tense and threatening situations. Peer support, talking, and discussions of experiences are pointed out as relevant by all social workers. Receiving training and support (in formal settings) in order to learn how to deal with vulnerable groups could be positive for their work and their professional and personal quality of life.
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Affiliation(s)
- María Dolores Ruiz-Fernández
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.D.R.-F.); (R.O.-A.); (J.M.H.-P.); (C.F.-S.)
| | - Rocío Ortiz-Amo
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.D.R.-F.); (R.O.-A.); (J.M.H.-P.); (C.F.-S.)
| | - Elena Andina-Díaz
- Department of Nursing and Physiotherapy, University of León, 24071 León, Spain
- SALBIS Research Group, University of León, 24071 León, Spain
- EYCC Research Group, University of Alicante, 03690 Alicante, Spain
- Correspondence: (E.A.-D.); (I.M.F.-M.); Tel.: +34-987-293101 (E.A.-D.); +34-950-214611 (I.M.F.-M.)
| | - Isabel María Fernández-Medina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.D.R.-F.); (R.O.-A.); (J.M.H.-P.); (C.F.-S.)
- Correspondence: (E.A.-D.); (I.M.F.-M.); Tel.: +34-987-293101 (E.A.-D.); +34-950-214611 (I.M.F.-M.)
| | - José Manuel Hernández-Padilla
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.D.R.-F.); (R.O.-A.); (J.M.H.-P.); (C.F.-S.)
- Adult, Child and Midwifery Department, School of Health and Education, Middlesex University, London NW4 4BT, UK
| | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.D.R.-F.); (R.O.-A.); (J.M.H.-P.); (C.F.-S.)
- Faculty of Health Sciences, University Autónoma of Chile, Temuco 3580000, Chile
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Mette J, Wirth T, Nienhaus A, Harth V, Mache S. "I need to take care of myself": a qualitative study on coping strategies, support and health promotion for social workers serving refugees and homeless individuals. J Occup Med Toxicol 2020; 15:19. [PMID: 32607123 PMCID: PMC7318459 DOI: 10.1186/s12995-020-00270-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 06/18/2020] [Indexed: 11/23/2022] Open
Abstract
Background Social workers provide support for various groups of clients, such as refugees and homeless people. Refugees and homeless individuals represent particularly vulnerable groups in precarious living conditions. Therefore, social workers serving these clients are likely to be confronted with extensive job demands. The aim of this study was to investigate the coping strategies of social workers serving refugees and homeless individuals and to explore their support sources and health promotion offers at work as well as their respective needs. Methods 26 semi-structured qualitative interviews were carried out with social workers in Berlin and Hamburg and analysed according to Mayring’s qualitative content analysis. Results The respondents reported various coping strategies to deal with their job demands which involved both problem-oriented (e.g. time management, setting boundaries, seeking support in conflict situations) and emotion-focused approaches (e.g. self-care, distance from work, leisure activities). In addition, they emphasised various sources of workplace (social) support, e.g. provided by team members, supervisors, and other institutions. However, unmet needs for support were also formulated by the workers, e.g. in terms of individual supervision and regular exchange. Furthermore, several employees did not know about any health promotion offers at their workplace and expressed a desire for structural and behavioural health promotion measures. Conclusions In view of the diverse needs of the workers, the results can provide a basis to design needs-based health promotion interventions for staff in social work.
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Affiliation(s)
- Janika Mette
- Institute for Occupational and Maritime Medicine, University Medical Centre Hamburg-Eppendorf, Seewartenstr. 10, 20459 Hamburg, Germany
| | - Tanja Wirth
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistr. 42, 20246 Hamburg, Germany
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistr. 42, 20246 Hamburg, Germany.,Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33/35/37, 22089 Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine, University Medical Centre Hamburg-Eppendorf, Seewartenstr. 10, 20459 Hamburg, Germany
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine, University Medical Centre Hamburg-Eppendorf, Seewartenstr. 10, 20459 Hamburg, Germany
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19
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Analyzing the Job Demands-Control-Support Model in Work-Life Balance: A Study among Nurses in the European Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082847. [PMID: 32326169 PMCID: PMC7215557 DOI: 10.3390/ijerph17082847] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 01/23/2023]
Abstract
The balance of personal life with professional life is a topical issue that is increasingly worrisome due to globalization, the rapid introduction of new technologies into all areas of human life, the overlap between time between work and family, new organizational systems, and changes in the nature of work. This problem is accentuated by professions subjected to intense labor demands, as is the case of nurses. Adopting the Job Demand–Control–Support model, the main purpose of this research is to analyze how these factors lead to a greater or lesser degree of work–life balance. The research proposes a logistic regression model, which was constructed with a sample of 991 nursing professionals from the V European Working Conditions Survey. The results obtained confirm, on the one hand, that there is a significant effect of physical demands (but not psychological demands) on work–life balance. On the other hand, the moderating effects of job control are partially confirmed for psychological demands, and those of supervisor support (but not co-worker support) are partially confirmed for physical demands. In conclusion, the present research shows that effective management of nurses’ work context can decisively contribute to finding the difficult balance between personal and professional time.
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Wirth T, Mette J, Nienhaus A, Schillmöller Z, Harth V, Mache S. "This Isn't Just about Things, It's about People and Their Future": A Qualitative Analysis of the Working Conditions and Strains of Social Workers in Refugee and Homeless Aid. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203858. [PMID: 31614734 PMCID: PMC6843662 DOI: 10.3390/ijerph16203858] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/08/2019] [Accepted: 10/11/2019] [Indexed: 11/16/2022]
Abstract
Large parts of Europe have been affected by an influx of refugees and increasing homelessness in recent years. Social workers provide care services for refugees and homeless people, but little is known about their working conditions. The aim of this study was to examine their job demands, resources and health strains. 26 semi-structured interviews were conducted with social workers in refugee and homeless aid in Hamburg and Berlin between October and December 2017. The interviews were analysed following Mayring's qualitative content analysis. Additionally, the job demands and resources of social workers with and without long-term psychological strain were compared. Respondents particularly experienced demands concerning their job content and work organisation, including emotional and quantitative demands. Appreciation expressed by clients and social support from the team served as key resources. Respondents had problems switching off from work, were exhausted and exhibited signs of long-term psychological strain, such as symptoms of burnout or depressive states. Workers reporting long-term psychological strain were more likely to consider themselves as being adversely constrained by legal requirements and to describe inadequate supervision offers and team conflicts. In conclusion, the results indicate the need for job-specific health promotion measures reducing particularly demands concerning social workers' job content and work organisation and further strengthening their social support.
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Affiliation(s)
- Tanja Wirth
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Janika Mette
- Institute for Occupational and Maritime Medicine, University Medical Centre Hamburg-Eppendorf, 20459 Hamburg, Germany.
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany.
| | - Zita Schillmöller
- Department Health Sciences, Faculty of Life Sciences, Hamburg University of Applied Sciences, 21033 Hamburg, Germany.
| | - Volker Harth
- Institute for Occupational and Maritime Medicine, University Medical Centre Hamburg-Eppendorf, 20459 Hamburg, Germany.
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine, University Medical Centre Hamburg-Eppendorf, 20459 Hamburg, Germany.
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