Wounded Healers? Exploring the Physical and Emotional Health of Early-Career Child Welfare Workers

Background

“Wounded healers”, a concept introduced by Jung (1966), acknowledges the phenomenon of mental health service providers experiencing their own behavioral health problems that can impact their work. Despite its obvious relevance, little has been done to inform our understanding of how the notion of “wounded healers” affects social workers. One recent exception showed that, out of over 6,000 U.S.-based licensed clinical social workers, over 50% reported experiencing some type of behavioral health problem during their career (Straussner, Senreich, & Steen, 2018). To contribute to the knowledge about wounded healers in social work, this study examined changes in seven self-reported behavioral health indicators among newly-hired child welfare workers during their first 18 months of employment.  

 

Methods

Using data from Wave 1 (baseline) to Wave 4 (18-months) of the Florida Study of Professionals for Safe Families, this study assessed changes in seven indicators of workers’ self-reported behavioral health over the first 18 months of employment. The sample is a cohort of 597 child welfare workers who provided responses at each of the four waves. Categorical measures included: perceptions of physical health and mental health (dichotomized into excellent/very good or not), and alcohol and tobacco use in the past 30 days (yes/no).  Continuous measures included psychological distress, sleep disturbance, and days drinking in the past month beyond recommended guidelines of the U.S. Department of Health & Human Services. Means and percentages were calculated to determine changes across waves. Chi square tests and paired-samples t-tests were conducted to evaluate statistical significance. 

 

Results

Overall, self-reported behavioral problems worsened over the first 12-months of employment. However, many of the reported declines leveled off by 18-months.  For example, the percentage of respondents who indicated their physical health was excellent or very good declined from 56.3% at W1 to 40.1% at W3 and remained at 40.1% at W4. This pattern was similar for alcohol use in the past 30 days, number of days drinking beyond recommended guidelines, and psychological distress. Perception of mental health stands out an exception as the percentage indicating excellent or very good mental health declined steadily from 72.5% at W1 to 46.5% at W4, a notable 36% decline.  All but tobacco use were significantly worse at W4 when compared to baseline.

Implications

Echoing concerns about wounded healers identified by Straussner and others (2018), this study found that early-career child welfare workers reported high rates of behavioral health issues. Workers reported poorer physical and mental health, more psychological distress, sleep disturbance, and increased alcohol use across time. While several of the problem areas stabilized by 18-months, they did not return to baseline functioning.  Agencies must have a robust plan to address the physical and psychological sequelae of child welfare casework as behavioral health consequences develop early in a worker’s tenure. Moreover, research is needed to determine the impact of behavioral health problems among early-career child welfare workers on meeting job expectations, particularly related to client service delivery.