Compassion fatigue and vicarious traumatization can result from continual exposure to trauma, violence, and marginalization, as experienced by both clients and social workers. The pervasiveness of these issues and their consequences throughout the social work field makes discussion among students, faculty, and field instructors essential with students entering the profession. Field seminar courses, which examine real-world social work practice through the lens of the student field practicum, offer a key venue for these crucial discussions of compassion fatigue and vicarious traumatization. Further, the traditional view that self-care provides a sufficient antidote for burnout may oversimplify the experiences of social work students and may miss opportunities to encourage students to reflect critically on the individual, community, and systemic factors that contribute to compassion fatigue and secondary trauma in social work practice. Discussing experiences of moral injury in practice and adopting a pedagogical model that enhances social work students’ resilience in challenging practice landscapes may also encourage more honest, inclusive, and equitable conversations in the classroom. This article examines the pivotal role that field seminar courses can play in advancing discussions beyond self-care by prompting students to reflect critically on their experiences and build strategies for resilience as emerging social workers.
Overview: Stressors and Negative Outcomes Among Contemporary Social Workers
Burnout, compassion fatigue, and secondary trauma are well-known problems in the social work field. Numerous studies have highlighted their persistence and negative impact on social workers and the clients they serve (Hussein, 2018; Jakel et al., 2016; Simon, et al., 2008; Wood et al., 2017). In the face of COVID-19 and highly visible racial injustices nationwide, many social workers and social work students have been overwhelmed by the combination of stressors they are required to manage (Peinado & Andreson, 2020). Social workers and social work students not only must ensure their own safety and well-being in the face of social isolation and anxiety about an uncertain future; they must also assist clients and work within systems that may be more overwhelmed and disjointed than usual (Joshi & Sharma, 2020). Additionally, many social workers and students are communicating and delivering services in virtual formats, often requiring new skill acquisition and increased work and patience in an already challenging time (Hansel, 2020). Moreover, social workers leading efforts for social change may be particularly vulnerable to burnout due to the emotional and physical tolls that accompany activist work, which often faces a lack of tangible supports (Chen & Gorski, 2015). In sum, today’s social workers are more susceptible than ever to burnout, compassion fatigue, and secondary trauma.
Because social workers have an imperative to uphold the National Association of Social Workers (NASW) code of ethics (NASW, 2017) despite the prevalent difficulties they face, social work programs must teach students how these difficulties can manifest in their personal and professional lives and how best to address them. To this end, university social work programs are striving to raise students’ awareness of adverse outcomes by emphasizing the importance of self-care for ensuring the resilience of social work professionals (Cox & Steiner, 2013; Smullens, 2012). Although research recognizes challenges in identifying theoretical and evidence-based models of self-care and translating this knowledge into practical techniques, virtually all discussions of the topic conceptualize self-care as the antidote for burnout among social workers (Newell & Nelson-Gardell, 2014).
Self-Care in the Field Seminar
Current research examining social work curricula affirm the field practicum as an optimal environment for practicing strategies of self-care. This literature notes that students find their field practicum to be one of the most stressful parts of their educational experience due to the emotional and psychological toll of their work and the challenge of balancing their multiple responsibilities in a professional social work setting (Griffiths et al., 2019; O’Neill et al., 2019). Consequently, the field seminar course, which integrates coursework and the field practicum, presents an ideal venue for exploring adverse outcomes faced by social workers and for allowing students to apply and practice self-care strategies.
In our university’s social work curriculum, the field seminar course is used in just this way: to teach students about the ethics of attending to adverse outcomes in the profession and raise their awareness of methods to address those outcomes. Following the literature on best practices for self-care pedagogy when designing course content and assignments can encourage students to plan and reflect on their own self-care practices and strategies (Lewis & King, 2019; Moore et al., 2011).
Critique of Self-Care
At the same time, students’ critiques of how self-care is currently conceptualized in their coursework highlight social workers’ responsibility to interrogate simplistic ideas that can perpetuate harmful social norms. For instance, students expressed concerns that several suggested activities of self-care taught in their courses (e.g., bubble baths, massages, dining out, taking trips) entailed different forms of privilege, such as having the ability to take time off from work, the means to pay for extracurricular activities, and the emotional capacity to incorporate such self-care activities into their lives. Additionally, students expressed concern that the self-care model being taught in their coursework often implied that it was their individual responsibility to cope with stressors even as they participated in an academic system that is incompatible with healthy work–life balance. This concern is echoed in findings by Squire and Nicolazzo, who observed “competitive, individualistic” and output-driven qualities in graduate student conversations on self-care and attributed these qualities to an academic environment that prized productivity at the expense of student well-being (Squire & Nicolazzo, 2019, p. 5). As a result of this framing, students may see self-care as a thing to be achieved rather than as a way of being. Finally, students noted that the traditional self-care model does not account for systemic impediments to well-being such as marginalization, economic deprivation, lack of access to needed resources, or racial injustice, meaning that the methods of self-care they are being taught are ill-equipped to address these issues (Nayak, 2020). Ultimately, students have voiced that the typical model of self-care for burnout is exclusionary of diverse experiences and needs and conceptualized from a deficits-based perspective.
Moral Injury
The concepts of moral injury and provider resilience have emerged as compelling holistic alternatives to the traditionally individualistic concepts of burnout and self-care. Originating in military contexts, moral injury is defined as “lasting psychological, spiritual and social harm caused by one’s own or another’s actions in high-stakes situations that transgress deeply held moral beliefs and expectations” (Haight et al., 2016, p. 27). Unlike the term “burnout,” this externalized etiology avoids pathologizing the social worker’s personal response to their experiences of systemic deficits and oppressive frameworks in nonoptimal environments. Moral injury acknowledges that a helping professional’s desire to implement interventions compassionately and ethically can conflict with their lack of resources or the restrictive policies of a work environment. Moral injury can result in psychological and existential distress and can impact an individual’s decision to remain in their work environment or chosen profession (Haight et al., 2016).
Moral injury is a demonstrably useful concept for helping students identify and understand the stress that can occur when their own belief systems conflict with the values of a client system. For instance, one MSW student in our program described an experience of providing family therapy in which their own moral injury became apparent. In the family receiving therapy, the caregivers were raising an adolescent questioning the gender identity they were assigned at birth. Due to the caregivers’ religious beliefs, they did not support their adolescent’s identity struggle. The MSW student struggled to validate the caregivers’ perspective because it clashed with her own value system. The student was able to name this experience by viewing it as a moral injury and seeking support from her field supervisor and field advisor.
Provider Resilience
Similar to the nonpathologizing perspective of the moral injury model, the provider resilience model was developed to address adverse outcomes experienced by military health care providers (Weidlich & Ugariza, 2015). Provider resilience acknowledges that social workers and other human-service providers face significant adversity in their professional roles that may stem from individual, institutional, or systemic factors. The provider resilience framework utilizes the Professional Quality of Life Measure, a self-assessment tool, to measure levels of compassion satisfaction, compassion fatigue, and secondary traumatic stress among providers (Klein et al., 2018; Stamm, 2009), and then uses this self-assessment data to help users identify and track goals related to their professional and personal well-being. Through regular reassessments and goal tracking, several studies have demonstrated the effectiveness of these methods in decreasing adverse outcomes for individual providers and raising organizational awareness of satisfaction in the workplace (Klein et al., 2018; Smoktunowicz et al., 2019; Wood et al., 2017). Notably, the provider resilience model also encourages the use of this assessment information in supportive supervision and in broader organizational planning (Stamm, 2009). That is, this model assumes a shared responsibility among the social worker, supervisor, and organizational administration to address the complexities of moral injury in the profession.
The provider resilience model offers a useful tool for social work students because (a) it acknowledges that social workers will face adversity in their professional capacities due to the fragmented and often oppressive systems in which they work; and (b) it moves beyond a limited focus on individual self-care by instead examining the organizational and systemic factors essential to supporting professional well-being. Ultimately, the provider resilience model may enhance students’ understanding of the complexities of the practice landscape and equip them with tools to navigate many challenging aspects of the social work profession.
Provider Resilience in Field Seminar
In traditional self-care models, the onus falls on the individual social work student to manage their own self-care. The transition to a provider resilience framework has enabled our seminars to think more broadly about the workplace, community, and policy contexts in which students in field seminar practice. Field seminar is a key community in which students can support each other when wrestling with challenging experiences in the field. Establishing community commitments and expectations of support has enabled students to build strong relationships with each other and with the seminar leader. Creating this trusting environment has been essential to encouraging discussions that critique the self-care modality and introduce concepts that underlie provider resilience. In our field seminars, we explore burnout, secondary trauma, compassion fatigue, and moral injury in order to encourage students to assess their experiences at their field placements. For example, are their supervisors or others at the agency experiencing any of these challenges? If so, what kinds of supports are available for workers at individual and agency levels, and do they meet workers’ needs? What institutional barriers affect provider resilience, and what strategies might be helpful to push against oppressive systems? Answering these questions empowers students to assess frankly any negative outcomes they experience as part of their work, identify the contributing factors to those outcomes, and develop strategies for attending to those outcomes.
In our field seminar, students complete a reflection paper in which they consider their own ecological system in the contexts of their agency and wider community in order to assess their own supports and challenges. Importantly, this paper coincides with their development of their own genogram and ecomap in another course. These two assignments logically interact to encourage students to develop insight about their personal history and current experience as a social work student. The assignments and discussion in field seminar enable students to consider how to balance their needs against the rigors of graduate school and the realities of practice within (often) oppressive systems.
Applications to the Explicit and Implicit Curriculum
Promoting social workers’ resilience will require closely examining our adherence to outdated and harmful models of well-being that are incompatible with our profession and the needs of our students. To that end, this article suggests a new paradigm for promoting resilience that includes a systems-level focus on fostering community care that better aligns with the contexts in which today’s students are working and learning. Moving beyond the “self-care for burnout” model requires ensuring that field seminar course curricula gather student input and budget class time to discuss the terminology currently used to describe the social work experience. This discussion should allow for critiquing the ideas of burnout as an individual failing and self-care as a panacea for this deficiency.
Additionally, faculty must make space to determine collaboratively with students how to address their current needs. Discussions and assignments that acknowledge and offer solutions for addressing structural and ideological barriers to self-care will help students feel empowered to create a more personalized and holistic approach to ensuring their well-being. Intentionally building time into the field seminar for community care that is not tied to a quantifiable measure can foster deeper connections between students and build important relationships that students need during graduate school.
Social work programs are no longer environments filled solely with traditional students; rather, they are reflective of shifting demographics and our field’s emphasis on greater inclusion of individuals holding diverse identities that better reflect the communities being served. As such, faculty should recognize these important changes in the social work field and give attention to the unique needs of each student. We must also examine our own complicity in perpetuating a performative and potentially detrimental model of self-care, and collaboratively cultivate the community of care we seek to model for our students. Finally, a provider resilience model must accurately name moral injury and help students reckon with the conundrum of being at once a worker, participant, service provider, and recipient within a flawed—if evolving—service system, while endeavoring to follow their own ethical and moral compass.
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