Adverse Childhood Experiences and Professional Quality of Life Among Direct Support Professionals

Background & Purpose

Direct support professionals (DSPs) assist individuals with intellectual and developmental disabilities (IDD) in activities of daily living and skill development.  Organizations struggle to recruite and retain DSPs given high turnover rates.  Research regarding DSPs and turnover has largely focused on burnout.  The purpose of the present study was to use a trauma-informed framework to explore individual and organizaitonal factors (i.e. adverse childhood experiences, emotional intelligence, challenging behavior, and organizational culture) and their associations with DSPs' professional quality of life.

Methods

The study design for the present research was cross-sectional.  Purposive sampling was used to recruit participants from 7 IDD agencies and two online social media groups for DSPs.  Data was collected via an online survey comprised of various measures, including adverse childhood experiences (Felitti et al., 1998),emotional intelligence measure (Schutte, 1998), ProQOL (Stamm, 2010), and trauma-informed organizational culture measure (Waldrop et al., 2010).  Data was collected for approximately 6 months and was analyzed using stepwise regressions.

Results

Although ACE scores were largely unrelated to the 3 ProQOL scales (i.e. compassion satisfaction, burnout, and secondary traumatic stress), 30% of DSPs had ACE scores >3,  nearly 2x that of comparison studies.  Additionally, about 20% of DSPs were at risk of burnout and/or secondary traumatic stress.  DSPs' perception of organizational culture was neutral to positive, suggesting that IDD organizations foster an environment consistent with trauma-informed care (Harris & Fallot, 2001).  Predictive models accounted for about 50% of variance in compassion satisfaction and burnout, with emotional intelligence and organizational culture having significant direct effects.  However, predictive models for secondary traumatic stress only accounted for approximately 15% of variance, with emotional intelligence having a significant direct effect.  Interactions between emotional intelligence and organizational culture or exposure to challenging behavior were most often not significant.

Conclusions & Implications

DSPs often experience challenging behavior while working with individuals with IDD.  DSPs may also have personal histories involving considerable adversity.  However, emotional intelligence and perception of organizational culture as defined by the principles of trauma-informed care are more influential than exposure to challenging behavior or ACEs in predicting professional quality of life.  In an effort to foster wellbeing among DSPs and to sustain their employment, organizations should consider providing DSPs with training to foster emotional intelligence and foster organizational cultures that emphasize choice, collaboration, empowerment, safety and trustworthiness (Harris & Fallot, 2001).