Missing the Mark?

Reframing NASW's Ethical Mandate for Self-Care as a Social Justice Issue

Authors

  • Dawn Apgar Seton Hall University
  • Mackaully Parada

DOI:

https://doi.org/10.18060/25748

Keywords:

self-care, burnout, social justice, ethics, macro practice

Abstract

The 2021 revision to the ethical code for social workers mandated engagement in self-care. A review of workforce data suggests that the need for self-care in social work is largely due to poor working conditions, inadequate pay, unavailability of quality supervision, and lack of professional recognition. Thus, making self-care largely a personal responsibility is adopting a “blaming the victim” mentality that the profession has historically rejected in its approach to client problems. Social work is rooted in examining the social conditions of people within their environments and focusing on making macro level changes to remedy systemic problems. Though not intentional, the ethical mandate for social workers to remedy the stress, trauma, and burnout resulting from environmental stressors is misplaced, though not surprising. In recent years, social workers have focused more on working with individuals to fix their problems rather than making contextual changes that are largely responsible for the ills. This article reframes the emotional and psychological problems experienced by social workers as a social justice issue, requiring mezzo and macro, rather than micro, level intervention. Embracing this alternative perspective requires a commitment to mobilization, advocacy, and political engagement—approaches that have been deprioritized by many within the social work profession.

References

American Medical Association [AMA]. (2021). Physician health. https://www.ama-assn.org/practice-management/physician-health

American Nurses Association [ANA]. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/

ANA. (2021). ANA's COVID-19 self-care package for nurses. https://www.nursingworld.org/continuing-education/anas-covid-19-self-care-package-for-nurses/

American Psychological Association [APA]. (2016). Ethical principles of psychologists and code of conduct. American Psychologist, 57(12), 1060-1073. https://doi.org/10.1037/0003-066X.57.12.1060

APA. (2021). Self-care resource center. https://www.apa.org/education-career/grad/self-care

Andrews, H., Tierney, S., & Seers, K. (2020). Needing permission: The experience of self-care and self-compassion in nursing—a constructivist grounded theory study. International Journal of Nursing Studies, 101(1), 1-10. https://doi.org/10.1016/j.ijnurstu.2019.103436

Apgar, D. (2021). Developing the next generation of social work activists: Support for eliminating the micro–macro divide, Journal of Community Practice, 29(1), 62-78. https://doi.org/10.1080/10705422.2021.1881856

Apgar, D., & Cadmus, T. (2021). Using mixed methods to assess the coping and self-regulation skills of undergraduate social work students impacted by COVID-19. Clinical Social Work, 50, 55-66. https://doi.org/10.1007/s10615-021-00790-3

Association of Social Work Boards [ASWB]. (2018). ASWB strategy map 2014–2018. https://aswbannualreport.org/2015-annual-report/aswb-strategy-map/

ASWB. (2022). History. https://www.aswb.org/about/history/

ASWB. (2023). Laws and regulations database. https://www.aswb.org/regulation/laws-and-regulations-database/

Bailey, R., & Brake, M. (Eds.). (1975). Radical social work. Arnold.

Baker, L. (2020). Self-care amongst first-year teachers. Networks: An Online Journal for Teacher Research, 22(2), 1-16. https://doi.org/10.4148/2470-6353.1328

Barck-Holst, P., Nilsonne, Å., Åkerstedt, T., & Hellgren, C. (2021). Coping with stressful situations in social work before and after reduced working hours, a mixed-methods study. European Journal of Social Work, 24(1), 94-108. https://doi.org/10.1080/13691457.2019.1656171

Barnett, J., & Cooper, N. (2009). Creating a culture of self-care. Clinical Psychology: Science and Practice, 16(1), 16-20. https://doi.org/10.1111/j.1468-2850.2009.01138.x

Blackburn, L. M., Thompson, K., Frankenfield, R., Harding, A., & Lindsey, A. (2020). The THRIVE© program: Building oncology nurse resilience through self-care strategies. Oncology Nursing Forum, 47(1), 25-34. https://doi.org/10.1188/20.ONF.E25-E34

Bloomquist, K. R., Wood, L., Friedmeyer-Trainor, K., & Kim, H. (2016). Self-care and professional quality of life: Predictive factors among MSW practitioners. Advances in Social Work, 16(2), 292-311. https://doi.org/10.18060/18760

Burghardt, S. (2021). The end of social work: Defense of the social worker in times of transformation. Cognella Academic Publishing.

Burke, D., & Carton, R. (2013). The pedagogical, legal, and ethical implications of unpaid internships. Journal of Legal Studies Education, 30(1), 99-130. https://doi.org/10.1111/j.1744-1722.2013.01115.x

Canadian Psychological Association [CPA]. (2017). Canadian code of ethics for psychologists (4th ed.). https://cpa.ca/docs/File/Ethics/CPA_Code_2017_4thEd.pdf

Centers for Disease Control and Prevention [CDC]. (2021). Care for yourself. https://www.cdc.gov/mentalhealth/stress-coping/care-for-yourself/index.html

Cheung, M., & Leung, C. (2020). Laughter yoga as a social work intervention. Smith College Studies in Social Work, 90(4), 288-301. https://doi.org/10.1080/00377317.2020.1819938

Council on Social Work Education [CSWE]. (2014, February 25). Internships, Department of Labor regulations, and social work field education: Setting the record straight. https://www.cswe.org/getattachment/Accreditation/2014-02-25AnnouncementreDOLandField-EF.pdf

CSWE. (2015). Curricular guide for licensing and regulation. Author. https://www.cswe.org/education-resources/2015-epas-curricular-guides/2015-licensing-and-regulation-guide-web-version/

CSWE. (2020). 2019 Statistics on social work education in the United States. https://www.cswe.org/Research-Statistics/Research-Briefs-and-Publications/2019-Annual-Statistics-on-Social-Work-Education

CSWE. (2021). National Workforce Initiative. https://www.cswe.org/about-cswe/governance/commissions-and-councils/commission-on-research/research-statistics/national-workforce-initiative/

CSWE. (2022). 2022 EPAS: Educational policies and accreditation standards for baccalaureate and master’s social work programs. https://www.cswe.org/getmedia/94471c42-13b8-493b-9041-b30f48533d64/2022-EPAS.pdf

Cox, K., & Steiner, S. (2013). Self-care in social work: A guide for practitioners, supervisors, and administrators. NASW Press.

Dalphon, H. (2019). Self-care techniques for social workers: Achieving an ethical harmony between work and well-being. Journal of Human Behavior in the Social Environment, 29(1), 85-95. https://doi.org/10.1080/10911359.2018.1481802

DeMarchis, J., Friedman, L., & Eyrich Garg, K. (2022). An ethical responsibility to instill, cultivate, and reinforce self-care skills. Journal of Social Work Education, 58(2), 308-316. https://doi.org/10.1080/10437797.2021.1895932

Dirik, D., Sak, R. & Şahin-Sak, I. (2021). Compassion fatigue among obstetricians and gynecologists. Current Psychology, 40, 4247-4254. https://doi.org/10.1007/s12144-021-02022-w

Douglass, R. (2016). "You are in a better position to protect people when you feel like you're protected yourself": To what extent does union membership and ethical clinical social work practice align? Master’s Thesis, Smith College, Northampton, MA. https://scholarworks.smith.edu/theses/1705

Dreher, M., Hughes, R., Handley, P., & Tavakoli, A. (2019). Improving retention among certified nursing assistants through compassion fatigue awareness and self-care skills education. Journal of Holistic Nursing, 37(3), 296-308. https://doi.org/10.1177/0898010119834180

Farr, P. (2021). Social workers of the world unite! A call to unionize the social work profession. International Social Work, 64(3), 449-453. https://doi.org/10.1177/0020872820948941

George Washington University, Health Workforce Institute and School of Nursing. (2017). Profile of the social work workforce. https://www.cswe.org/research-statistics/national-workforce-initiative/profile-of-the-social-work-workforce/

George Washington University, Health Workforce Institute. (2019). From social work education to social work practice results of the survey of 2018 social work graduates. https://www.cswe.org/CSWE/media/Workforce-Study/2018-Social-Work-Workforce-Report-Final.pdf

George Washington University, Health Workforce Institute. (2020). The social work profession: Findings from three years of surveys of new social workers. https://www.cswe.org/CSWE/media/Workforce-Study/The-Social-Work-Profession-Findings-from-Three-Years-of-Surveys-of-New-Social-Workers-Dec-2020.pdf

Gillen, V., Myers, W., & Tennille, J. (2021). Impact of paid internships for MSW students. https://digitalcommons.wcupa.edu/swgrad_stuwork/2/

Gitterman, A. (2014). Social work: A profession in search of its identity. Journal of Social Work Education, 50(4), 599-607. https://doi.org/10.1080/10437797.2014.947898

Grise-Owens, E., & Miller, J. (2021, May 31). Self-care A-Z: National Association of Social Workers (NASW) Code of Ethics (CoE) 2021 updates include self-care—Celebrations and crucial caveats. The New Social Worker. https://www.socialworker.com/feature-articles/self-care/national-association-social-workers-nasw-code-of-ethics-2021-self-care/

Hardy, T., Hobdy, D., & Asare Nti, S. (2021, May 18). 2021 Revisions to the NASW Code of ethics: Self-care and cultural competence [Virtual NASW Training]. https://naswinstitute.inreachce.com/Details/Information/757e97f0-7b33-4dc7-acb1-58776a2ecf66

Harmon, M. (2017). MSW students cite unpaid field positions as contributor to financial instability. The Michigan Daily. https://www.michigandaily.com/news/academics/msw-students-cite-unpaid-field-positions-contributor-financial-instability/

Holden, G., & Barker, K. (2018). Should social workers be engaged in these practices? Journal of Evidence-Informed Social Work, 15(1), 1-13. https://doi.org/10.1080/23761407.2017.1422075

Hricová, M. (2020). The mediating role of self-care activities in the stress-burnout relationship. Health Psychology Report, 8(1), 1-9. https://doi.org/10.5114/hpr.2019.89988

Huerta, M. F. (2020). Social work graduates’ debt and life choices. California State University, Sacramento. http://hdl.handle.net/10211.3/216947

Hughes, J., Kim, H., & Twill, S. (2018). Social work educational debt and salary survey: A snapshot from Ohio. Social Work, 63(2), 105-114. https://doi.org/10.1093/sw/swy001

International Council of Nurses [ICN]. (2021). The ICN code of ethics for nurses. https://www.icn.ch/system/files/2021-10/ICN_Code-of-Ethics_EN_Web_0.pdf

Johnco, C., Salloum, A., Olson, K. R., & Edwards, L. M. (2014). Child welfare workers' perspectives on contributing factors to retention and turnover: Recommendations for improvement. Children and Youth Services Review, 47(3), 397-407. https://doi.org/10.1016/j.childyouth.2014.10.016

Kaplan, J. (2019). Self-care as self-blame redux: Stress as personal and political. Kennedy Institute of Ethics Journal, 29(2), 97-123. https://doi.org/10.1353/ken.2019.0017

Kelly, L. (2020). Burnout, compassion fatigue, and secondary trauma in nurses. Critical Care Nursing Quarterly, 43(1), 73-80. https://doi.org/10.1097/CNQ.0000000000000293

Lakioti, A., Stalikas, A., & Pezirkianidis, C. (2020). The role of personal, professional, and psychological factors in therapists’ resilience. Professional Psychology: Research and Practice, 51(6), 560-570. https://doi.org/10.1037/pro0000306

Law, M. T., & Kim, S. (2005). Specialization and regulation: The rise of professionals and the emergence of occupational licensing regulation. Journal of Economic History, 65(3), 723-756. https://doi.org/10.1017/S0022050705000264

Leigh, J., & Chakalov, B. (2021). Labor unions and health: A literature review of pathways and outcomes in the workplace. Preventive Medicine Reports, 24, 1-10. https://doi.org/10.1016/j.pmedr.2021.101502

Leung, P., Cheung, M., & Olson, L. (2020). Social work degrees and Title IV-E stipends: Predictive factors for worker retention in public child welfare. Child Welfare, 98(5), 75-92. https://www.proquest.com/openview/24527a7646dd23273a9eb28d02d49226/1.pdf?pq-origsite=gscholar&cbl=40853

Lightman, E. (1982). Professionalization, bureaucratization, and unionization in social work. Social Service Review, 56(1), 130-143. https://www.jstor.org/stable/30011543

Lilly, M. (2020). An apprenticeship model for the modern economy. Ai Group. https://cdn.aigroup.com.au/Reports/2020/Apprenticeship_Model_for_modern_economy_25Nov.pdf

Linton, M., & Koonmen, J. (2020). Self-care as an ethical obligation for nurses. Nursing Ethics, 27(8), 1694-1702. https://doi.org/10.1177/0969733020940371

Lloyd, C., King, R., & Chenoweth, L. (2002). Social work, stress, and burnout. Journal of Mental Health, 11(3), 255-265. https://doi.org/10.1080/09638230020023642

Mack, B. (2020). The resiliency-focused supervision model addressing stress, burnout, and self-care among social workers. Advances in Social Work, 20(3), 596-614. https://doi.org/10.18060/23897

Maranzan, K. A., Kowatch, K., Mascioli, B., McGeown, L., Popowich, A., & Spiroiu, F. (2018). Self-care and the Canadian code of ethics: Implications for training in professional psychology. Canadian Psychology, 59(4), 361-368. https://doi.org/10.1037/cap0000153

Matto, H., & Sullivan, K. (2021). Ashes2Art: Mitigation strategies for short- and long-term distress in emergency services personnel during COVID-19. Clinical Social Work Journal, 49, 437-444. https://doi.org/10.1007/s10615-021-00797-w

Mattsson, T. (2014). Intersectionality as a useful tool: Anti-oppressive social work and critical reflection. Affilia: Journal of Women and Social Work, 29(1), 8-17. https://doi.org/10.1177/0886109913510659

McCusker, P. (2021). Critical mindfulness in social work: Exploring the potential of reflexive self-care in the journey from student to social worker. The British Journal of Social Work, 51(1), 334-353. https://doi.org/10.1093/bjsw/bcaa246

McLaughlin, A. (2011). Exploring social justice for clinical social work practice. Smith College Studies in Social Work, 81(2-3), 234-251. https://doi.org/10.1080/00377317.2011.588551

Michelson, T., & Kluger, A. (2021). Can listening hurt you? A meta-analysis of the effects of exposure to trauma on listener’s stress. International Journal of Listening. https://doi.org/10.1080/10904018.2021.1927734

Miller, J., & Cassar, J. (2021). Self-care among healthcare social workers: The impact of COVID-19. Social Work in Health Care, 60(1), 30-48. https://doi.org/10.1080/00981389.2021.1885560

Miller, J., & Grise-Owens, E. (2020). Self-care: An imperative. Social Work, 65(1), 5-9. https://doi.org/10.1093/sw/swz049

Moore, S. (2021). Essential self-care for doctors during the pandemic. The International Journal of Whole Person Care, 8(1), 54-56. https://doi.org/10.26443/ijwpc.v8i1.278

Moss, J. (2020). Rethinking burnout: When self-care is not the cure. American Journal of Health Promotion, 34(5), 565-568. https://doi.org/10.1177/0890117120920488b

National Association of Social Work [NASW]. (2006). Assuring the sufficiency of a frontline workforce: A national study of licensed social workers. NASW Center for Workforce Studies. https://www.socialworkers.org/LinkClick.aspx?fileticket=OilZ7p_EEnE%3D&portalid=0

NASW. (2021). Code of ethics of the National Association of Social Workers. Author. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

Ofei-Dodoo, S., Cleland-Leighton, A., Nilsen, K., Cloward, J., & Casey, E. (2020). Impact of a mindfulness-based, workplace group yoga intervention on burnout, self-care, and compassion in health care professionals. Journal of Occupational and Environmental Medicine, 62(8), 581-587. https://doi.org/10.1097/JOM.0000000000001892

Omrani, O., Carmen, V., Bionat, J., Ghebreyesus, T., Fore, H., & Wickramanayake, J. (2021). COVID-19, mental health, and young people’s engagement. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2021.03.020

Oncology Nursing Society [ONS]. (2021). Nurse well-being learning library. https://www.ons.org/learning-libraries/well-being-nurses

Pace, P. (2017, July). Social worker says self-care is ethical responsibility. NASW News, 62(7), 1-16. http://digitaledition.qwinc.com/publication/?m=43320&i=419112&p=4&ver=html5

Paro, A., Hyer, J., Diaz, A., Tsilimigras, D., & Pawlik, T. (2021). Profiles in social vulnerability: The association of social determinants of health with postoperative surgical outcomes. Surgery, 170(6), 1777-1784. https://doi.org/10.1016/j.surg.2021.06.001

Posluns, K., & Gall, T. L. (2020). Dear mental health practitioners, take care of yourselves: A literature review on self-care. International Journal for the Advancement of Counselling, 42(1), 1-20. https://doi.org/10.1007/s10447-019-09382-w

Quinn, A., Pengsheng, J., & Nackerud, L. (2019). Predictors of secondary traumatic stress among social workers: Supervision, income, and caseload size. Journal of Social Work, 19(4), 504-528. https://doi.org/10.1177/1468017318762450

Reidy, J. (2021). Yes to occupational advocacy: First client – social workers. Social Work, 66(1), 82. https://doi.org/10.1093/sw/swaa054

Reisch, M., & Andrews, J. (2001). The road not taken: A history of radical social work in the United States. Brunner-Routledge.

Richardson, B. (2021, July 27). Take action: Sign now: Demand the Department of Labor crack down on unpaid internships [Member access only]. MyNASWCommunity. https://mynasw.socialworkers.org/communities/community-home/digestviewer/viewthread?GroupId=7&MessageKey=716bed12-fe25-4a63-95d0-1f2ad8f315c0&CommunityKey=47d18a47-1294-42c1-9142-240a44037b1a&tab=digestviewer

Richmond, M. (1917). Social diagnosis. Russell Sage Foundation.

Rogers, S., Miller, C., Flinchbaugh, C., Giddarie, M., & Barker, B. (2021). All internships are not created equal: Job design, satisfaction, and vocational development in paid and unpaid internships. Human Resource Management Review, 31(1), 1-13. https://doi.org/10.1016/j.hrmr.2019.100723

Santana, M. C., & Fouad, N. A. (2017). Development and validation of a self-care behavior inventory. Training and Education in Professional Psychology, 11(3), 140-145. https://doi.org/10.1037/tep0000142

Scanlon, E., & Harding, S. (2005). Social work and labor unions: Historical and contemporary alliances. Journal of Community Practice, 13(1), 9-30. https://doi.org/10.1300/J125v13n01_02

Scheyett, A. (2021). The responsibility of self-care in social work, Social Work, 66(4), 281-283. https://doi.org/10.1093/sw/swab041

Senate Banking, Housing, and Urban Affairs Committee. (2022, May 3). Listening session: How student loan debt impacts the dignity of work [YouTube]. https://www.youtube.com/watch?app=desktop&v=OY89ZHwujh8

Shaffer, G. (1979). Labor relations and the unionization of professional social workers: A neglected area in social work education. Journal of Education for Social Work, 15(1), 80-86. https://doi.org/10.1080/00220612.1979.10671548

Shields, P. (Ed.). (2017). Jane Addams: Pioneer of peace, philosophy, sociology, social work and public administration. Springer International Publishing. https://doi.org/10.1007/978-3-319-50646-3

Simon, J., Boyd, R., & Subica, A. (2022). Refocusing intersectionality in social work education: Creating a brave space to discuss oppression and privilege. Journal of Social Work Education, 58(1), 34-45. https://doi.org/10.1080/10437797.2021.1883492

Skovolt, T., & Trotter-Mathison, M. (2016). The resilient practitioner: Burnout and compassion fatigue prevention and self-care strategies for the helping professions (3rd ed). Routledge.

Slater, E. (2020). Private practice social workers’ commitment to social justice. Clinical Social Work Journal, 48, 360-368. https://doi.org/10.1007/s10615-020-00746-z

Smiley, R., Lauer, P., Bienemy, C., Berg, J., Shireman, E., Reneau, K., & Alexander, M. (2019). The 2017 national nursing workforce survey Journal of Nursing Regulation, 9(3), S1-S88. https://doi.org/10.1016/S2155-8256(18)30131-5

Smullens, S. (2015). Burnout and self-care in social work: A guidebook for students and those in mental health and related professions. NASW Press.

Specht, H., & Courtney, M. (1995). Unfaithful angels: How social work has abandoned its mission. Free Press. https://doi.org/10.1093/sw/40.1.134

Spencer, P., & Munch, S. (2003). Client violence toward social workers: The role of management in community mental health programs. Social Work, 48(4), 532-544. https://doi.org/10.1093/SW/48.4.532

Stuart, H. (2021). ‘Professional inefficacy is the exact opposite of the passionate social worker’: Discursive analysis of neoliberalism within the writing on self-care in social work. Journal of Progressive Human Services, 32(1), 1-16. https://doi.org/10.1080/10428232.2020.1790715

Ubinger, N. (2021). Code of ethics revisions – self-care policies [Member access only]. MyNASWCommunity. https://mynasw.socialworkers.org/communities/community-home/digestviewer/viewthread?GroupId=7&MessageKey=aaeda241-6833-47c0-b984-06f96d8edad6&CommunityKey=47d18a47-1294-42c1-9142-240a44037b1a&tab=digestviewer

U.S. Bureau of Labor Statistics [US BLS]. (2021a). Occupational outlook handbook: Physicians and surgeons. https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm

US BLS. (2021b). Occupational outlook handbook: Registered nurses. https://www.bls.gov/ooh/healthcare/registered-nurses.htm

US BLS. (2021c). Occupational outlook handbook: Social workers. https://www.bls.gov/ooh/community-and-social-service/social-workers.htm

U.S. Department of Education. (2021). Public service loan forgiveness data. https://studentaid.gov/data-center/student/loan-forgiveness/pslf-data

U.S. Department of Labor [US DOL]. (2018, January). Fact sheet #71: Internship programs under The Fair Labor Standards Act. https://www.dol.gov/agencies/whd/fact-sheets/71-flsa-internships

U.S. News. (2021). Affordability rankings: Determining the most affordable states. https://www.usnews.com/news/best-states/rankings/opportunity/affordability

van der Merwe, A., & Hunt, X. (2019). Secondary trauma among trauma researchers: Lessons from the field. Psychological Trauma: Theory, Research, Practice, and Policy, 11(1), 10-18. https://doi.org/10.1037/tra0000414

Vaughan, K. (2017). The role of apprenticeship in the cultivation of soft skills and dispositions. Journal of Vocational Education & Training, 69(4), 540-557. https://doi.org/10.1080/13636820.2017.1326516

Wei, H., Kifner, H., Dawes, M., Wei, T., & Boyd, J. (2020). Self-care strategies to combat burnout among pediatric critical care nurses and physicians. Critical Care Nurse, 40(2), 44-53. https://doi.org/10.4037/ccn2020621

Williams, N. (2015). Fighting fire: Emotional risk management at social service agencies. Social Work, 60(1), 89-91. https://doi.org/10.1093/sw/swu053

Wilson, F. (2016). Identifying, preventing, and addressing job burnout and vicarious burnout for social work professionals. Journal of Evidence-Informed Social Work, 13(5), 479-483. https://doi.org/10.1080/23761407.2016.1166856

Wise, E., Hersh, M., & Gibson, C. (2012). Ethics, self-care and well-being for psychologists: Reenvisioning the stress-distress continuum. Professional Psychology: Research and Practice, 43(5), 487-494. https://doi.org/10.1037/a0029446

World Health Organization [WHO]. (2022). WHO guideline on self-care interventions for health and well-being, 2022 revision. https://apps.who.int/iris/rest/bitstreams/1440452/retrieve

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2023-03-22