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Self-Care Deserves More Than Lip Service
By Sue Coyle, MSW
Social Work Today
Vol. 21 No. 3 P. 24

The past year has amplified the overwhelming need for social workers to address self-care. Will the experience have a lasting effect?

Prior to COVID-19, many social work trainings, meetings, and conferences would start with an announcement: “If anything gets to be too much for you, if you need a break, take it. Take care of yourself first.”

There likely would be crayons, Play-Doh, and candy on the table for fidgeting and, when needed, distraction as well. The message was that self-care was a priority to the hosts. At least, it was important enough to mention.

The problem—a problem that has become clearer over the course of the pandemic—is that mentioning it is often as far as most social workers went. Self-care has historically been more of a theory than a reality.

“It’s really hard to practice self-care,” says Crystal Hayes, MSW, a clinical assistant professor at Sacred Heart University’s School of Social Work. “When you think about the average social worker, the average agency—because we’re working in communities that are under duress, because they’ve been divested from—you have to be able to do more than one thing. I remember being a frontline social worker. You would give lip service to self-care, but it was never really anything that was built into the way that we actually practiced our work day to day.”

COVID-19 has given social workers the opportunity to change that. By examining the ways in which the pandemic has forced social workers to adapt to a changing world and equally a world that has not changed at all, social workers can focus in on how individual and professionwide acts of self-care have an impact.

COVID-19’s Impact
The pandemic affected social workers in multiple ways. For some, it meant an immediate pivot to telework. As offices and schools closed, client meetings, classes, and more were hosted on video platforms. In some ways, this saved social workers’ time. However, it also added to the day and blurred the line between work and home.

Elizabeth Mulvaney, MSW, LCSW, a clinical assistant professor at the University of Pittsburgh’s School of Social Work, says the transition to an online environment required new approaches and ways of thinking. “There was a learning curve to come up to speed on the different ways to interact with people, to think about how do I really connect with them in these different formats? Connecting with students in this format is really different, and helping them connect to one another is really different,” she notes. “Some of the activities that I had been doing took a lot more time and a lot more energy.”

Sara Planthaber, JD, MSW, a recent graduate of the University of Pittsburgh, agrees. “There are technically more hours to do things, but everything takes longer. You don’t actually have more time. Your days are just consumed,” she says.

Planthaber and fellow graduate Marla Holland, MSW, worked on a project this past year in which they interviewed professionals, including social workers, working with older adults and substance use. They similarly found that in moving to telehealth, the professionals were able to see more clients and had never been busier, for better or worse.

For social workers unable to move online, their days brought new challenges. They attempted to navigate ever-evolving guidelines and information about COVID-19 while serving their clients and keeping everyone—including themselves—safe. This was often challenging, particularly when social workers weren’t granted access to the same resources being provided to other frontline workers.

“The pandemic only exacerbated and amplified the existing inequities within our communities—social workers had to fight to be seen as essential health care workers to gain access to personal protective equipment and, later, vaccines,” says Ryan R. Lindsay, MSW, LCSW, an associate professor of practice at the Brown School at Washington University in St. Louis and chief operating officer at Sparlin Mental Health.

Additionally, many social workers—like all frontline workers through the pandemic—were unable to take the time away from work that they needed to refuel. Holland remembers hearing of an essential worker (not a social worker) in New York who was only able to step back from his job when he became ill. “His break from COVID was getting COVID,” she says.

Outside of work, social workers had to adapt to the needs of their families as well. For example, as of August 2020, an estimated 93% of households with school-age children had experienced some form of distance learning. Parents—most often mothers—had to determine how to meet the needs of their employer while also supervising and caring for their children. Such responsibilities had a big impact on social workers, largely in part because of social work’s makeup.

“Eighty percent of social workers identify as female, and we know that women have borne the major brunt of the caretaking responsibilities and remote learning of their children. As a consequence, it has led to a major exodus from the workforce due to these untenable contexts,” Lindsay says.

More Than a Pandemic
For many social workers, specifically those who are Black, Indigenous, and people of color, the pandemic has carried even more weight—not necessarily through the changes it has brought but rather through the existing truths it has spotlighted.

The pandemic has disproportionately impacted people of color. As the Centers for Disease Control and Prevention notes, “Longstanding systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of dying from COVID-19.” Witnessing and experiencing the increased risk and the subsequent deaths have taken a toll.

“COVID only magnified what was already there,” Hayes says. “It magnified all the things that are wrong and all the ways that we have been dying pre-COVID from preventable diseases.

“COVID is a preventable disease. It is a virus that you can prevent if you have a health care system in place that wants to keep people alive,” she continues. “But we happen to live in a world that we don’t have the kind of health care system that is invested in keeping people alive. And we certainly don’t have one that is invested in keeping poor people and people of color alive. So COVID, I felt, came in and blew the curtains wide open so everybody could see how the sausage gets made. Literally we were on death watch for a year, worried about ourselves, worried about family, worried about community. And every place that you turned when you turned on cable news, there was a death ticker, reminding you of how many people died that day, died that week, died that month.”

What’s more, COVID-19 was not the only crisis occurring in the country. In addition to a presidential campaign featuring hints of white supremacy and racism, police killings of Black men and women continued throughout the pandemic.

“For the two of us, sitting here as clearly Black women, the impact of COVID for us is very different than it is for many of our colleagues,” says Elizabeth Johnson-Tyson, LMSW, MSW, a clinical assistant professor at Sacred Heart University’s School of Social Work, referencing both herself and her colleague Hayes. “This year wasn’t just COVID for us. This year was also COVID in the Black community and a whole lot of killings, which isn’t out of the norm but they were recorded this time. Add to the fact that you are a parent, a Black parent of Black children, Black young adults, and that throws in a whole other thing. Actually, I think I could deal with COVID a lot better if we weren’t getting killed all the time.”

Self-Care in the Moment
In short, COVID-19 has pushed many social workers to the brink, though the heft of that push has varied for individuals and differing subsets of social workers. “Everyone is in crisis,” says Elaine K. Hammond, MSW, adjunct faculty at the University at Buffalo School of Social Work.

Being in crisis has forced social workers to assess their self-care and take steps in the present to better manage it. Some have looked to maintain the routine of exercise. Mulvaney has swapped swimming for yoga, Planthaber goes for runs, and Holland plays disc golf. Meanwhile, others have reinforced their prepandemic practices.

Johnson-Tyson, for instance, has remained focused on setting and maintaining boundaries. “I’m big on setting boundaries for myself and other people, and so that continues, but it’s far more pronounced now because it’s just harder,” she says. “I think that’s one of the kindest things you can do for yourself and for someone else. Honestly, if you don’t set a boundary for a person who is really pushing it, eventually you get to a place where you’re really ticked off at them or you’re just sick of talking to them. That’s not compassion. For me to be kind to someone else, I need to maintain a boundary.”

Perhaps most importantly, social workers have attempted to combat the isolation that was inevitable amid the lockdowns. “Social workers lean on their fellow colleagues for informal gatherings and drop-ins to help process the emotional events of the day. This too was eliminated,” Lindsay says. “Most of the strategies that we know help social workers prevent burnout, prevent susceptibility to secondary traumatic stress, and thus [foster] self-care were eliminated or made much more difficult as they were no longer organic.”

Zoom happy hours and dinners, as well online networking, have become common practice among professionals. However, it has not filled the gap effectively. “It’s a lot harder to make connections and to make friends,” Planthaber says. “You hit ‘leave meeting’ and that’s kind of it.”      

Self-Care Moving Forward
Unfortunately, much of what is being done in the name of self-care right now is reactive. It is action put in place because of an ongoing crisis. “Our self-care becomes very stopgap,” Hammond says. “What am I going to do in this second to get through this little bit of time?”

What could happen—and likely already is—is that as “normal” returns, so does the standard relationship social workers have with self-care. “Prior to the pandemic, social workers were less likely to take self-care seriously unless one was suffering from burnout or compassion fatigue,” says Mirean Coleman, MSW, LICSW, CT, NASW clinical manager, who is determined to maintain self-care even after the pandemic. “Moving forward, I will take my vacation time from work, engage in mindfulness, block time daily to do a favorite activity, and pay attention to my physical health.”

However, that is often easier said than done. A future without change is likely to allow social workers to drift back into old habits. The best and most effective way for social workers to keep this from happening is to take a broader view of self-care.

Self-care is not only what someone is doing today but rather what social workers as a group of professionals are doing to advocate for their needs and how others should be awakened to meet those needs.

“It is a fallacy to think, feel, or believe that we are going back to some idealized past,” Hammond says. “If you were paying attention two or three years ago, it wasn’t that great. Even people who were thriving in many ways were also in many ways impoverished around their personal relationships, sleep, and fun. So, how are we going to build a new world?”

To do so will require social workers to stand up for their value and educate those outside of the profession about what they add to society. “I think we have always known our value,” Johnson-Tyson says. “The problem is the rest of the world has not. The reality is we’re kind of everywhere, but we need to work and to eat like everyone else. So many people who are essential workers have us to help support them. And we don’t get acknowledged.”

By advocating for respect and recognition, social workers may give themselves a platform to improve working conditions, pay, and, among other things, the opportunity for self-care.

On a more internal level, social workers must take greater care to recognize their limits as individuals and as a profession. The flexibility of social work means that social workers can be and are everywhere, but it does not mean they can be and do everything.

“It isn’t that we need to become a profession of specialists, but it’s good self-care to know how you can make an impression on the world,” Hammond says. “A lot of what has changed for me in self-care is that we cannot be all things to all people. There are things about our profession that expect us to do that. Part of the message that I’ve had to give out is you not only have to pick your battles but you also have to pick your war.”

Johnson-Tyson agrees. “Social work does not answer all of the hard questions. Social work does not prevent half of the things that we would like to see prevented in this world,” she says. “The only thing we can do as social workers is our part.”

 — Sue Coyle, MSW, is a freelance writer and social worker in the Philadelphia suburbs.