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Volume 11, Issue 3, July 2023 Evidence in Action A quarterly research brief from the Center on Trauma and Children
Implementation of STS-Informed Organizational Change in Child Welfare
Whitt-Woosley, A., & Sprang, G. Analysis of implementation drivers of secondary traumatic stress (STS)-informed organizational change and experiences of STS and burnout in child welfare. Child Abuse & Neglect, 2023 Jul;141:106194.
The Study
Background: Secondary traumatic stress (STS) can result from indirect exposure to the trauma of others, leading to symptoms similar to Posttraumatic Stress Disorder (1) . Burnout refers to exhaustion, depersonalization, and a reduced sense of personal accomplishment that can result from chronic exposure to workplace stressors (2). Child welfare workers are particularly vulnerable to both of these conditions. Prior research has established the negative consequences of STS and BO on child welfare workers including decreased productivity and engagement with clients, as well as higher turnover rates (3) Studies are increasingly finding that organizational factors also significantly contribute to STS such as inadequate support and training, unsafe workplace culture and conditions and limited resources (4).
Method: This study focuses on strategies for enhancing well-being and promoting resilience for child welfare professionals by examining organizational factors potentially contributing to STS, as well as the role of strategies for implementation of STS-informed organizational change. The Secondary Traumatic Stress Organizational Assessment (STSI-OA) tool has been increasingly utilized as a structure for examining the activities of organizations directed at promoting the resilience of helping professionals, and this tool was employed as the basis for this investigation (5). Also, the National Implementation Network Research (NIRN) framework was utilized, which outlines key stages of exploration, installation, initial implementation, and full implementation in organizations attempting to enact change and adopt best practices. The NIRN framework further emphasizes the role of competency, organization and leadership as critical implementation drivers in supporting and sustaining change (6).
An integrated model presented by Sprang and colleagues combines elements from the STSI-OA and the NIRN framework to guide successful implementation of STS-informed initiatives in organizations7. Specific activities identified by the STSI-OA were found to associate with each of the three implementation drivers. This study conducted a secondary analysis of data from online surveys completed by child welfare professionals in two statewide social service systems in the United States. The participants (N= 382) included frontline child welfare workers (69.4%), followed by support staff (19.1%), child welfare leadership (6.1%) and other child welfare professionals (5.4%). The survey included measures of individual STS and BO, as well as STS-informed organizational activities across five domains (resilience, safety, policies, leader practices and organizational practices). These activities were also organized by the three implementation drivers of competency, organization and leadership. The dependent variables in the study were individual experiences of STS and BO. Hierarchical regression models were used to examine the associations between the implementation drivers of STS-informed organizational activities and these measures of individual well-being.
Findings: Analyses revealed that in this sample of child welfare professionals, scores for STS-informed organizational practices were below reported averages for a national sample of various helping professionals. Individual STS and BO scores were moderate-high on average with a subset of workers experiencing very high levels of STS. Increased use of STS-informed activities affiliated with all three implementation drivers was significantly associated with lower individual STS and BO scores. STS-informed activities associated with the organization driver seemed particularly effective for addressing STS. The findings suggest the need for organizations to prioritize and implement STS-informed organizational practices to mitigate the negative effects of STS and BO in child welfare workers. Future research should focus on longitudinal studies to track changes in these variables over time.
Translational Tips
- A bifocal approach is recommended for addressing (STS) in the workplace, involving both individual and organizational strategies to create environments that support the well-being and resilience of helping professionals.
- In the child welfare context, strategies should focus on front-line workers and include safety promotion, resilience building and key leadership practices.
- Safety-enhancing strategies including Low Impact Processing can reduce unnecessary exposures or allow experiences to metabolize effectively.
- Organizations should provide workers with resilience-promoting methods, self-monitoring tools and access to evidence-based trauma treatments when necessary through programs like Employee Assistance Programs or external providers.
References
- Figley, C.R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York, NY: Brunner/Mazel.
- Maslach, C. (2003). Job burnout: New directions in research and intervention. Current Directions in Psychological Science, 12, 189-192.
- Boyas, J., & Wind, L.H. (2010). Employment-based social capital, job stress, and employee burnout: A public child welfare employee structural model. Children and Youth Services Review, 32(3), 380-388.
- Deaver, A. H., Cudney, P., Gillespie, C., Morton, S., & Strolin-Goltzman, J. (2020). Culture of safety: Using policy to address traumatic stress among the child welfare workforce. Families in Society, 101(4), 428–443. https://doi.org/10.1177/1044389420912127
- Sprang, G., Ross, L., Blackshear, K., Miller, B. Vrabel, C., Ham, J., Henry, J. & Caringi, J. (2014). The Secondary Traumatic Stress Informed Organization Assessment (STSI-OA) Tool. University of Kentucky Center on Trauma and Children, #14-STS001, Lexington, Kentucky.
- Fixsen, D.L. & Blase, K.A. (2008). Drivers framework. Chapel Hill, NC: University of North Carolina, The National Implementation Research Network, Frank Porter Graham Child Development Institute.
- Sprang, G., Ross, L. A., & Miller, B. (2018). A data-driven, implementation-focused, organizational change approach to addressing secondary traumatic stress. European Journal for Person Centered Healthcare, 6(1), 62–68. https://doi.org/10.5750/ejpch. v6i1.1400
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