Across the world, studies have shown high levels of stress and burnout among social workers. This is caused partly by the stressful nature of the work itself and partly by work environments – for instance, time spent completing forms or the tensions of trying to provide support for individuals and their families from limited resources.

This study used the concept of ‘caregiver role identity’ (Siebert and Siebert 2005) to examine social workers’ risk of stress and burnout. It is based on the premise that everyone has multiple roles – employee, parent, partner and so on. Social workers have overlapping professional and personal identities as caregivers, reinforced by the expectations of service users, those of their family and friends, and their own expectations of themselves.

When faced with differences between the actual work they are able do and their ideal of what they should be doing, social workers may begin to channel all their efforts into the ‘caregiver role’, staying late at work and setting aside other aspects of their lives. Even this may still not be enough, either because there is still too much work to be done or because their performance has become affected. This opens them to risk of stress. By this time, they have become so enmeshed in the ‘caregiver role’, they may not even realise, or accept, what is happening to them (Siebert and Siebert 2005).

Methods

The study data are drawn from responses to an online survey completed by a random sample of licensed social workers living and working in Kentucky, a state famous for bluegrass music and horses but also blighted by rural poverty. Licensing is similar to registration but often involves an examination and evidence of supervised practice, sometimes for as long as two years. In the United States, social workers are licensed at state level and different states have their own regulations.

The researchers used four scales that had already been pre-tested to ensure they were reliable and valid. These measured:

• caregiver identity;
• self-esteem;
• social support; and
• distress

Results

Respondents were mainly women, white, with around 15 years experience as social workers. They worked in a variety of settings. Almost a third worked in mental health, and a fifth with children and families. Almost one in ten worked in private practice. The researchers did not have access to data that would have enabled them to tell if respondents differed in any important ways from non-responders.

The researchers undertook a series of hierarchical regression analyses. These showed that as respondents’ scores on the Caregiver Role Identity Scale increased (got worse) so their scores on the distress scale also grew exponentially. Exponential growth is not fixed but increases by a fixed rate at each interval. Plotted on a graph, the line showing the relationship between distress and caregiver identity is not straight but curved, becoming steeper as scores on each scale become higher.

Crucially, however, respondents with high self-esteem and good social support had lower scores on both measures. The term used to describe this effect is ‘buffering’.

Conclusions

The researchers concluded that low self-esteem and low social support increased social workers’ vulnerability to the negative effects of identifying too much as a caregiver. Helping social workers to develop and maintain good self-esteem and good social support could have benefits not only for workers themselves but also for the individuals and families they support.

Strengths and limitations

This is an entirely quantitative study and assumes readers are familiar with the statistics used to analyse their findings. The phrase ‘strong caregiver role identity’ to describe those scoring highly on Caregiver Role Identity Scale is also confusing. It is not an intuitively negative term – nobody would want to have an uncaring social worker. It is only when the text is read closely that it becomes clear why this might be a source of concern.

However, while this research is not an easy read, it is definitely a worthwhile one and provides new evidence on an important topic.

Its main strengths are that the data are drawn from a clearly defined sampling frame, everyone had an equal chance of taking part in the survey, and self-esteem, social support, distress and caregiver identity were all measured the same way. The researchers are open about the comparatively low response rate (17%) and did as much as possible to take account of it in analysing their data.

Its chief limitation is that it is based on a cross sectional survey. This means that it is not possible to say over-identification with the caregiver role causes low self-esteem or reductions in social support or vice versa. It can only demonstrate the strength of the relationships between them.

Another limitation is its reliance upon US research. The international social work literature discusses concepts like role ambiguity and role conflict (for example, Coyle et al. 2005, Carpenter et al. 2015) and this could have contributed to the researchers’ thinking.

Summary

This study offers different messages for social work managers, social work educators, and social workers themselves. For social work managers, the relationship between stress and a strong caregiver role identity highlights the need for them to find ways of creating supportive teams and ensuring staff maintain a good work-life balance.

Results from a survey published last year (Grant et al. 2014) showed social work educators are increasingly aware of the need to help students become emotionally resilient practitioners. We need more evidence from follow up studies examining how effective this learning is once students are faced with the realities of practice.

A headline in Community Care dramatically announced that social workers are ‘more likely to turn to food than to managers as way of coping with stress’ (McGregor 2013) but we have got very little systematically collected information about the strategies that social workers in the United Kingdom adopt to try and counteract the effects of stress at work. This study highlights how much more could be done to utilise practitioners’ own expertise.

Link

Wu, C. & Pooler, D. (2014), Social workers’ caregiver identity and distress: examining the moderating role of self-esteem and social support. Social Work Research, 38, 4: 237-249. [Abstract]

References

Carpenter, J., Shardlow, S. M., Patsios, D. & Wood, M. (2015), Developing the confidence and competence of newly qualified child and family social workers in England: outcomes of a national programme. British Journal of Social Work, 45, 1: 153-176. [Abstract]

Coyle, D., Edwards, D., Hannigan, B., Fothergill, A. & Burnard, P. (2005), A systematic review of stress among mental health social workers. International Social Work, 48, 2: 201-211. [Full Text]

Grant, L., Kinman, G. & Baker, S. (2014), ‘Put on your own oxygen mask before assisting others’: social work educators’ perspectives on an ‘emotional curriculum’. British Journal of Social Work, available at http://dx.doi.org/10.1093/bjsw/bcu066, accessed 6 February 2015. [Abstract]

McGregor, K. (2013), Social workers more likely to turn to food than to managers as way of coping with stress. Community Care, 2 December 2013. [Full Text]

Siebert, D. C. & Siebert, C. F. (2005), The Caregiver Role Identity Scale: a validation study. Research on Social Work Practice, 15, 3: 204-212. [Abstract]