Self-Care Among MSW Students: Exploring the Relationships with ACEs and Self-Compassion

Background and Purpose: Childhood impacts on health and wellbeing increase risks for adverse health and social outcomes in adulthood. Yet, the mechanisms by which adverse childhood experiences (ACEs) influence social behaviors are not fully understood. Self-care practices may help assuage daily and sustained life demands and stress, yet less is understood as to what mechanisms may impede or interfere with these behaviors. The current study examined if adverse childhood experiences affect self-care behaviors through resulting in lower levels of self-compassion.

The current study examined (1) if ACEs directly relate to self-care behaviors, and (2) if this relationship is partly accounted for by deteriorated levels of self-compassion, among a sample of MSW students.

Methods: Drawing from a larger study that investigated the prevalence of ACEs among undergraduate and graduate students, we took an analytic subset of 260 MSW students who participated in an online survey administered in March 2022. We used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to assess the quality of measures and to examine the direct and indirect relationships between ACEs, self-compassion, and self-care practices. ACEs were specified as two correlated latent variables: (1) Abuse-Related ACEs were assessed by 5 binary items (e.g., experiencing physical abuse) and (2) Non-Abuse Related ACEs were assessed by 9 binary items (e.g. witnessing intimate partner violence). Self-compassion was specified as two latent variables of with one reflecting positive self-compassion aspects (Positive Self-Compassion) that included self-kindness, common humanity, and mindfulness, and the other reflecting negative aspects of self-compassion that included isolation, self-judgment, and over-identification behaviors. These latent variables were assessed by 12 (5-point Likert) items from the Self Compassion Scale (Raes et al., 2011). ACEs were assessed from six items that derived from the Philadelphia Adverse Childhood Experiences questionnaire (Cronholm et al., 2015). Model fit for CFA and SEM used the following indices: Chi Square Test of Model Fit (x²_(df)), Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI).

Results: The majority of participants identified as White (n= 84.6%), female (89.6%), and heterosexual (79.6%). SEM model fit demonstrated acceptable fit, (x²₍₂₉₂₎= 412.670 [p<0.01], RMSEA= 0.041 [CI: 0.031-0.050], CFI= 0.958, TLI= 0.953). Contrary to our expectations, neither the abuse-related nor non-abuse-related ACEs demonstrated statistically significant relationships with either self-compassion or self-care behaviors. However, higher levels of self-compassion were associated with higher levels of self-care (B= 0.32, p<0.01), such that, increases in self-compassion were related to increases in self-care behaviors.

Conclusion: While a history of ACEs was not associated with self-care practices, this study found that students’ sense of self-compassion plays a direct role in their self-care, such that increases in self-compassion are associated with increases in self-care. Social work education programs should consider programming that encourages students to build or enhance their sense of self-compassion as a means to promote self-care practices.