Professor Dede Sparks wants to raise awareness for the often unseen work that social workers do, the toll it can take, and how to build resilience for the days ahead.

By Dede Sparks

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Dede Sparks is the Assistant Dean for Health Affairs and Clinical Associate Professor at The Steve Hicks School of Social Work at The University of Texas at Austin.

Over the past several months, we’ve seen numerous reports on the emotional and physical strain the COVID-19 pandemic has placed on our medical providers. Less visible, the nation’s social workers have been on the frontlines since day one as we’ve dealt with the economic, psychological, medical, and social fallout of the crisis.

As social workers, our tools are invisible, we don’t wear uniforms, and much of our work is done behind closed doors or, lately, on telehealth platforms. As a country, we should not let that diminish the value of what social workers are doing, and we need to acknowledge the impact these trying times are having on those who work in the profession.

As a social worker, if you have a client sitting across from you, they have an unmet need — food, housing, safety. Within that need, there are profound emotions, like fear or loss or grief, and, in most cases, the client has experienced some form of suffering and trauma around that need.

In order to address client needs, the social worker must listen to clients’ stories in order to understand not just the need, but how that loss is impacting the individual. What are the cultural influences? The spiritual influences? What are the systemic barriers the client is facing? And, in listening to their story – their narrative – we hold what we hear, what we witness.  

Often, when bearing daily witness to the suffering and trauma of others, it can feel easier in the moment to ignore our own grief response, to minimize our own emotional and physical needs, and to compare our own suffering to the magnitude of those we serve. Eventually, our ability to pretend we aren’t affected by the work we’re doing becomes impossible. Our physical, emotional, and spiritual needs overwhelm our ability to hide them, and the result is what’s known as secondary trauma. 

Secondary trauma is the emotional threat that occurs when someone hears about the first-hand trauma experiences of another. It is the leading cause of burnout within our professional community. 

Burnout, or compassion fatigue, is a process that evolves over time. It develops gradually, which is why so many people don’t recognize they’re experiencing it until a significant event happens, until they absolutely hit rock bottom or until they start hearing from people around them: You really seem to be having a hard time. You need to take a break. What’s wrong? What’s going on with you?

Think of a rubber band. If you stretch it out and let go, it will bounce back to its original shape. But if it’s stretched repeatedly, it will eventually lose its shape and warp or snap.

When the rubber band can’t bounce back, the consequences are serious psychological and physical damage. Our capacity for empathy, compassion, and creativity in our work is exhausted. It becomes difficult to maintain awareness and sensitivity to our own experiences and those of others around us, making it extraordinarily difficult to care for ourselves or others. 

Secondary trauma and compassion fatigue are risks that social workers face under normal working conditions. In a crisis like the current pandemic, when the needs of our clients multiply dramatically, the threat becomes all the greater.  

Systemic barriers, such as limited federal, state, and local funds, increase the probability of experiencing secondary trauma, compassion fatigue, and burnout. Instabilities in the systems we depend on to meet our clients’ needs – political, legislative, healthcare, and other direct-service delivery systems – as well as systemic racism, sexism, and ageism, also have a direct impact on our own resilience and that of our clients.  

Volunteers load boxes of food and hygiene items into cars at Del Valle High School on Monday, April 20, 2020. Central Texas Food Bank distributed boxes of shelf stable food and personal hygiene products to Central Texans experiencing food insecurity. CTFB has seen the demand for food grow more than 200% in February and March due to the COVID-19 crisis, and they have responded by setting up several mobile pantry locations like this one which served over 1500 families in the span of a few hours.
Volunteers load boxes of food and hygiene items into cars at Del Valle High School as part of a Central Texas Food Bank distribution event. The economic fallout from the COVID-19 pandemic has left many people experiencing food insecurity who have never experienced it before. [Photo by Kelly West]

We have to remember that this is a time when many social workers are themselves experiencing financial insecurity, housing insecurity, food insecurity, day-care issues, trying to work from home, homeschooling their own children, worrying about the health of their family and friends, and possibly grieving the loss of loved ones.  

Social workers are also feeling afraid, anxious, and uncertain about the future. Moreover, the pandemic has created a moral dilemma for many social workers who, in order to support their clients in-person, may have to put themselves or their own families at risk since much of our work cannot be done remotely.

This tension between the desire to help and the limitations of the systems we work in can ultimately lead to profound feelings of guilt, shame, and anger amongst social workers. And as the COVID-19 pandemic has amplified many of these experiences among social workers, cultivating resilience is the key to protecting ourselves from the dangerous consequences of the pandemic. 

Resilience is how people cope with or recover from challenging experiences in their lives that cause personal and environmental stressors and emotional trauma. It’s our ability to bounce back after being stretched like the rubber band.

Resilience begins with being realistic about what we are able to do, being courageous enough to reflect on our own experiences, being willing to tell our own story, and offering ourselves the same compassion we offer our clients.

Do we depend on life-depleting coping skills, such as substance use, self-isolation, participating in risky behaviors, and the “extremes” – eating too much or too little, sleeping too much or not enough? Or do we invest in life-sustaining coping skills like exercising, eating healthy or building relationships.

One of the best ways to strengthen our resilience as social workers is to invest in a strong support system. Even if it’s online, through social media, by phone call, or waving at neighbors – all of these make a difference in terms of resiliency.

More than friends and relatives, when we maintain a network of social workers, we can reach out and tell them what we’re feeling without having to talk about our clients specifically. We can say: 

I just talked to my fourth client today who’s going to be evicted this week. And I’m feeling so sad.

I lost four patients today, and they all died without their family there.

I’m feeling anxious.

As social workers, we understand what each other’s work entails. We understand the need to talk – to process – what we are feeling and what we are witnessing. We know what “hard” means, what tired feels like. Needing to talk about it doesn’t mean you’re not a good social worker. It doesn’t mean you’re weak. It means we’re determined to care for ourselves, that we understand that we can’t help others until we’ve put on our own oxygen masks.

In my classes at The University of Texas, I make sure to tell my students what I always told my hospice patients and their families: It’s okay to have a bad day. Don’t be afraid of it. Plan for it. Learn to listen to your body. Create a plan for how to care for yourself when you know your personal and professional resilience is being challenged.

When I talk to students about this, they sometimes become concerned and ask, “How am I going to take care of myself? I don’t want to make a mistake. I don’t want to be traumatized by the work I do.” 

My response is to tell them that you are going to make mistakes. You are going to be affected by the suffering you witness. You are going to be emotionally and physically exhausted at times. That’s a given. It’s how you care for yourself during those times, the compassion that you show yourself, and the support you receive that matters most. 

I think what challenges social workers more than anything is when they can see the need clearly — the hunger, the sickness, the grief, the fear — and they don’t have the ability to make those things go away. 

The truth is, as this crisis goes on, the needs of our clients will only increase, while resources will become harder to access. As social workers, we will remain on the frontlines throughout, committed to those we serve and to our own families and friends. 

Ask a social worker and they’ll tell you that social work isn’t something you do. It’s how you live your life. It’s who you are. 

When I go out these days, I wear a mask that reads: I am a social worker because your life is worth my time.

In writing this, I want every social worker out there to know that your lives are worth all of our time.

Dede Sparks, Assistant Dean for Health Affairs at the Steve Hicks School of Social Work, University of Texas at Austin.
Above and top photo: The author Dede Sparks, LMSW, in the Steve Hicks School of Social Work at the University of Texas at Austin. Sparks teaches healthcare social work classes, including Loss and Grief, and Patient and Provider Healing: Topics on Death, Dying and Resilience. Before joining the faculty at UT Austin, Sparks practiced in inpatient hospice and palliative care. [Photo by Jim Tuttle]