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Short and long term PTSD symptoms documented in child welfare workers

by David Mandel

The March/April 2009 Child Welfare League of America publication Children’s Voices cited a recent study conducted by the New York Administration for Children Services in conjunction with the Mount Sinai School of Medicine which found significant evidence of short and long post traumatic stress symptoms in child welfare workers in New York City. The study which asked workers workers to identify their most distressing work related event found that one week later 60% reported “clinically significant post traumatic stress disorder symptoms.” The study also found that half of that group “continued to experience clinically significant PTSD symptoms an average of 2.15 years later.”

This number doesn’t surprise me. I’ve seen the impact of trauma in close colleagues and friends working in child protection and I know the effect first hand.  I’ve been part of many conversations about sleepless nights, weekends lost to fear and anxiety about cases and nightmares filled with violence.  I’ve seen individual workers and entire systems traumatized by the death of  a child.   Child welfare workers have shared with me how their work has intruded into their most private thoughts and relationships.

Given these numbers and experiences, we need to be thinking about how we can shift the child welfare culture to be more responsive to the needs of workers.  The CWLA newsletter described two models of how to respond to trauma exposure reaction and worker stress in a child welfare agency. The Administration for Children Services in New York developed the Resilience Alliance Project which provides 12 sessions of prevention intervention focused on building skills associated with optimism, mastery over negative emotion and in the area of self-care, and collaboration. Importantly the effort has targeted supervisors as well as workers, including a component to help supervisors integrate these skills into their supervisory practice.

Closer to home, Dr. Michael Schultz, a colleague of mine at Connecticut’s Department of Children and Families has been coordinating a series of efforts to support workers with , what he refers to as, worker related stress. Mike, along with others, recognizes that any effective effort to address the impact of the work needs to be broached in a sensitive manner. Workers are often resistant to discussing worker related stress or trauma exposure reaction for fear of being perceived as weak and unable to accomplish their work.  These attitudes are often embedded in the child welfare culture and internalized by workers. (Laura van Dernoot Lipsky directly addresses this issue in her book Trauma Stewardship—see April 14 blog entry) The Department’s efforts to sensitively address this issue have included peer led Worker Support Teams, which reach out to workers who are involved in critical incidents, and day long training for workers in worker related stress. The Department’s commitment to child safety, organizational development and worker well-being come together in staff debriefings after critical incidents. These debriefings blend attentiveness to the impact of the traumatic event on staff,  mutual support, organizational dynamics and the importance of learning lessons that may prevent future critical incidents.

If you want to read entire Children’s Voices article click here.

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