Secondary Traumatic Stress and the Child Welfare Workforce: A Case Study on Resilience

Background and Purpose

Secondary traumatic stress (STS) and job burnout can occur among Child welfare (CW) workers because of indirect exposure to trauma, high workloads, the vulnerable situations of their clients, the unpredictable nature of their jobs, and their relative lack of physical and psychological protection. Through a grant from the Children’s Bureau, the Quality Improvement Center for Workforce Development worked with a CW organization in a Midwestern state to develop an intervention tailored to the needs of the agency. The intervention was designed to help staff acquire enhanced skills of reflection, optimism, emotional regulation, coping, self-care and social support. There were two interventions chosen: Resilience Alliance and the Atlantic Coast Child Welfare Implementation Center (ACCWIC) Coaching Model. This presentation is an in-depth case study of one of the five intervention county sites which were part of a larger state-wide quasi-experimental study that addressed STS among all CW staff and leaders.

Methods

A case study design was chosen to thoroughly examine the implementation components of the intervention in a single CW organization allowing for an examination of how contextual factors influenced implementation. The primary units of analysis for this study included 1) direct observations from a key administrator, 2) interviews with CW staff who were involved in the implementation of, or participated in, the intervention, and 3) post-intervention survey administration to assess symptoms of STS from CW staff. Interviews were audio recorded and transcribed verbatim. To increase rigor, sequencing, use of multiple investigators in identifying themes, and triangulation of the data were employed. Univariate and bivariate analysis were conducted to determine if there were statistically significant STS survey scale scores for CW staff in the intervention versus comparison sites.

Results

Themes from a key administrator note the importance of pre-work, layering of the implementation, and shifting the agency culture. Themes from interviews with staff include importance of self-care, shared learning with others, inclusion of implementation leads, and changing agency culture. There were 84 CW workers who participated in completing the survey in the intervention county and 69 CW workers who completed the survey in the comparison sites. Total STS scale scores post-intervention were significantly lower for those in the intervention site (M=33.63, SD=11.10), compared with those in the comparison sites (M=37.60, SD=11.46), F(1,150) =4.75, p<.03. Engaging in active coping post-intervention was significantly stronger for those in the intervention site (M=17.12, SD=3.00), compared with those in the comparison sites (M=16.01, SD=3.13), F(1,152) =4.98, p<.03. Job satisfaction post-intervention was significantly higher for those in the intervention site (M=3.92, SD=.92), compared with those in the comparison sites (M=3.49, SD=1.09), F(1,150) =4.75, p<.03.

Discussion

Implementation of programming in large heterogenous organizations such as CW requires intentionality and careful planning. This case study of one county-administered CW site testing the efficacy of a multi-level intervention to address secondary trauma and improve resilience, coping, and a sense of social support demonstrated that the intervention was embraced by leadership and staff. Organizations may benefit from lessons learned from real world implementation in child serving systems.