STRESS AND SELF-CARE AMONG GRADUATE SOCIAL WORK STUDENTS
Sylia M. Olvera
B.A., California State University, Sacramento, 2009
PROJECT
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF SOCIAL WORK
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SPRING
2011
STRESS AND SELF-CARE AMONG GRADUATE SOCIAL WORK STUDENTS
A Project
by
Sylia M. Olvera
Approved by:
__________________________________, Committee Chair
Kisun Nam, Ph.D., MSSW
____________________________
Date
ii
Student: Sylia M. Olvera
I certify that this student has met the requirements for format contained in the University
format manual, and that this project is suitable for shelving in the Library and credit is to
be awarded for the Project.
__________________________, Graduate Coordinator
Teiahsha Bankhead, Ph.D., LCSW
Division of Social Work
iii
________________
Date
Abstract
of
STRESS AND SELF-CARE AMONG GRADUATE SOCIAL WORK STUDENTS
by
Sylia M. Olvera
This study recorded and identified the perceptions and thoughts regarding both stress and
self-care among graduate social work students. The implications stress has on social work
graduate students and its effects were also explored in this study. In addition the role selfcare plays in the lives of this population was revealed. Qualitative research was utilized
and data was collected in the form of one time semi-structured interviews. The sample
size of this study consisted of ten second year graduate social work students. The findings
of this study indicated that that graduate social work students experience high levels of
stress that affect various parts of their lives. In addition the results showed that graduate
social work students do engage in self-care activities and perceive that its benefits can
positively impact their lives as well as their practice in the field.
_______________________, Committee Chair
Kisun Nam, Ph.D., MSSW
_______________________
Date
iv
ACKNOWLEDGMENTS
I would like to acknowledge those who have been source of support throughout this two
year journey as well as those who have helped make the completion of this project
possible. To my Grandparents, my Mother, and my Aunt Esther, thank you for your
encouragement and love. To my colleagues, thank you for taking the time out of your
busy schedules to share your thoughts and stories, your contribution to this project is
greatly appreciated. To my friend April Blas, anytime I shared something with you I
always knew you would have something positive to say, thank you, you are a true social
worker. To my little Lola, thank you for being you. Finally, thank you Dr. Nam for your
help.
v
TABLE OF CONTENTS
Page
Acknowledgments............................................................................................................... v
Chapter
1. THE ISSUE ..................................................................................................................... 1
Introduction ............................................................................................................. 1
Background of the Issue ......................................................................................... 2
Statement of the Research Problem ........................................................................ 3
Purpose of the Study ............................................................................................... 3
Theoretical Framework ........................................................................................... 4
Definition of Terms ................................................................................................ 5
Assumptions............................................................................................................ 6
Justification ............................................................................................................. 6
Limitations .............................................................................................................. 7
2. REVIEW OF THE LITERATURE ................................................................................ 8
Introduction ............................................................................................................. 8
Symptoms Associated with Stress .......................................................................... 9
Eustress ................................................................................................................. 11
Stress and Graduate Students ................................................................................ 12
Burnout and Compassion Fatigue ......................................................................... 16
Self-Care Practices ................................................................................................ 19
Summary ............................................................................................................... 23
3. METHODS ................................................................................................................... 27
Research Design ................................................................................................... 27
Data and Sample ................................................................................................... 27
Measurement Instrument ...................................................................................... 28
Analysis Plan ........................................................................................................ 28
Protection of Human Subjects .............................................................................. 28
vi
4. FINDINGS .................................................................................................................... 30
Introduction ........................................................................................................... 30
Definitions of Stress.............................................................................................. 30
Stress as Motivation .............................................................................................. 31
Physical Impact Stress has on Graduate Students ................................................ 32
Graduate Students Interpersonal Relationships and Social Life ........................... 34
Graduate Students and Issues they Have in the Field Regarding Stress ............... 36
Perceptions on the Benefits of Self-Care .............................................................. 37
Types of Self-Care Utilized .................................................................................. 38
Support that Would Minimize Stress .................................................................... 40
Summary ............................................................................................................... 42
5. CONCLUSIONS, SUMMARY, RECOMMENDATIONS ......................................... 44
Introduction ........................................................................................................... 44
Conclusions ........................................................................................................... 44
Implications for Social Work Practice .................................................................. 46
Recommendations for Future Researchers ........................................................... 47
Summary ............................................................................................................... 48
Appendix A. Consent to Participate in Research .............................................................. 50
Appendix B. Interview Questions ..................................................................................... 53
References ......................................................................................................................... 54
vii
1
Chapter 1
THE ISSUE
Introduction
Throughout various points in life people experience different levels of stress.
The contributing factors to stress may vary from person to person however its effects
have the potential to impact lives. This study was inspired by the researcher’s experiences
with stress as well as the experiences with stress of many of the researcher’s colleagues.
The researcher and the researcher’s colleagues are social work graduate students who are
fulfilling both their field education and coursework concurrently. Being social work
graduate students and budding social workers comes with its challenges. Rigorous
coursework, assignments, and thesis/projects are all part of the lives of graduate students.
In addition social work graduate students have obligations to clients and field placements
as well which can prove to be exhausting but are very necessary and crucial to
broadening of their knowledge base. Graduate students are faced with having to manage
new responsibilities with already existing responsibilities and at the same time having to
balance different aspects of their lives. All these factors require having to make life style
adjustments and are some of what has contributed to the stress that is present in the lives
of graduate social work students.
How the issue of stress is dealt with varies as does the stress. In various social
work classes, both undergraduate and graduate courses, there has been some brief
discussion regarding self-care. In the brief discussion about self-care that has occurred in
2
these courses the focal point has been its importance and benefits within the realm of
social work. The reason self-care is relevant to the field of social work as well as students
is that it may prevent burnout and contribute to the well being of the social work graduate
student.
Background of the Issue
The beginning of what is considered by some to be the modern concept of stress
began in the 20th century and has been strongly influenced by the work of American
psychologist Richard Lazarus (Cooper & Dewe, 2004). Throughout his research Lazarus
noted that there was indeed a relationship between how a person’s experiences with their
environment and their coping strategies could create and affect their experiences with
stress (Cooper & Dewe, 2004). Currently stress is a wide spread psychological,
biological, and social issue that can have serious implications on an individual (American
Psychological Association, 2011). In particular graduate students, specifically social
work graduate students are exposed to stress due to the nature of the discipline and the
interactions they have with various systems. Graduate social work students have multiple
responsibilities and due to their dual roles as social worker and student they are prone to
stress and vulnerable to burnout, a byproduct of stress (Skovholt, 2001). Burnout and
elevated levels of stress can potentially affect both their field work and academic success.
Graduate students now are likely to encounter more complex problems and
responsibilities than graduate students in the past, some which can partly be attributed to
societal change and role management (Hyun, Quinn, Madon, & Lustig, 2006). The
3
combination of these pressures can be overwhelming and taxing upon a social worker and
student.
There is the additional factor of coping strategies regarding stress among this
population. Some graduate students and social workers alike may not have the tools to
learn how to cope with stress in healthful ways which will be beneficial to their learning
and practice. In this sense self-care is crucial to social work practice. It can be used to
improve the well being of social workers and social work students. Although it has been
noted that self-care is important to the profession of social work and preventing and
coping with stress it has yet to be fully explored (National Association of Social Workers,
2008). Overall the combination of stress and lack of self-care may lead to future
difficulties among this population.
Statement of the Research Problem
This researcher has observed that although there is some comprehensive
information regarding stress among students there is less that is solely geared towards
graduate students, specifically those who are fulfilling both their field education as well
as classroom education simultaneously. In addition there is a limited amount of
information on the perceptions and importance of self-care among this population. Due to
the limited amount of comprehensive information this issue warrants further study.
Purpose of the Study
The purpose of this study is to record and identify the perceptions and thoughts
regarding both stress and self-care among social work graduate students who are
4
concurrently fulfilling their field education and coursework. The implications of stress
and its effects on this population will be important to this study and therefore explored.
Self-care and perceptions of self-care, and the role it plays in the lives of social work
graduate students will be analyzed as well. Finally there will be an exploration in order to
answer whether or not stress and self-care affect their work in field education.
Theoretical Framework
To understand and explain the concept of stress in relation to social work graduate
students the systems theory is the framework that will be used to guide this study.
Systems theory is based on the idea that human behavior is the product of the interactions
a person has with various systems in their environment (Hutchinson, 2003). According to
this theory, systems are composed of interrelated parts which make a whole (KirstAshman & Hull, 2006). Different components of the system therefore have the potential
to have an effect on the other (Hutchinson, 2003). In addition these interactions between
systems can generate sudden changes that can affect equilibrium (Hutchinson, 2003).
These interactions and sudden changes with different systems and environments may
have the potential to create energy in the form of life stressors (Payne, 2005). Social
work graduate students interact with multiple systems. For example field placements, the
University, their families, peers, and clients are different types of systems that graduate
students interact with in one way or another on an almost daily basis.
Due to the interactions between graduate students and the different systems which
have been previously listed, the effects can be manifested in the form of daily life
5
stressors which can impact the lives and field work of graduate social work students.
Furthermore the stressors created by these systems can come in the form of deadlines,
increasing caseloads-some with challenging clients, as well as the lack of time to
accomplish some necessary tasks (Whitaker, Weisemiller, & Clark, 2006). In relation to
the systems theory self-care can be perceived as a way to cope with the adverse reactions
created by the interactions one has with their environment. Self-care calls for the
utilization of outside sources to promote overall well being which also includes working
with additional systems, an example being support from others. This overall well being
that is the result of self-care can have positive implications for practice and the daily lives
of graduate social work students.
Definition of Terms
Field. The term field will be used to generalize and refer to that which pertains to
practicum/internship and work with clients, client systems, and institutions.
Field Placement. Defined as the institution from which the student operates and
provides services.
Burnout. Defined as a response which is caused by the buildup of constant,
“emotional and interpersonal stressors” (Maslach, Shaufeli, & Leiter, 2001, p. 397).
Self-Care. Defined as, “Something one does to improve the sense of subjective
well-being” (Pincus, 2006, as cited in Richards, Campenni, & Muse-Burke, p. 248).
Stress. The definition of stress that will be used is provided by Monat & Lazarus
(2001). The authors define stress as “any event in which environmental demands, internal
6
demands, or both tax or exceed the adaptive resources of an individual, social system” (p.
3).
Stressor. Defined as internal or external factors which cause stress.
Assumptions
Since this study is qualitative and draws information from the personal
experiences and perceptions of the participants there are several assumptions. To begin
the researcher assumes that the participants of this study have had experiences with stress
and self-care. Furthermore there is the assumption that the participants will be able to
provide sufficient information and be knowledgeable about their perceptions and
thoughts regarding stress and self-care. It is also assumed that the participants will be
able to provide the researcher with information that will provide insight to this population
and its needs.
Justification
The stress and lack of effective stress management of social work graduate
students may potentially affect their facility to learn and effectively perform their duties
as both students and social workers. The tools and information that should be acquired in
graduate school may not be fully obtained due to the distractions that are part of stress
which may compromise competence. In these instances self-care is imperative to student
well being. There is also the potential for distractions, burnout, and overwhelming
feelings which may compromise work with clients. There is the need for practitioners and
students to practice self-care in order to manage these feelings and to also avoid burnout.
7
The mission of social work is to help improve the quality of life of others and its core
values are rooted in service as well as competence (NASW Code of Ethics, 1996), a
social worker who is experiencing excessive levels of stress and lack self-care may not
meet the mission of social work nor adhere to its core values.
Limitations
This project is specifically focused on graduate social work students and therefore
the findings of this study cannot be generalized to a broad range other disciplines.
Furthermore this study was conducted with a small sample of participants from California
State University Sacramento and the findings only represent a fraction of the graduate
students in this particular program. Furthermore the sample population consisted of only
second year graduate students and does not represent any of the perceptions and thoughts
of first year graduate students. Although there are many other social work programs the
findings of this study do not represent or reflect upon any other division or social work
program. In addition since this project is qualitative, the data collected is based on
personal experiences and thoughts and therefore statistical tests were not used during the
process of data analysis.
8
Chapter 2
REVIEW OF THE LITERATURE
Introduction
Throughout their college careers social work graduate students encounter a range
of changes and challenges which can have an effect on various parts of their lives.
Graduate student stress can be the result of a variety of factors. Some main contributors
to these challenges and changes are stressors and lack of self-care. These two factors can
affect the well being of a student. The review of the following literature will provide
some insight as to what information and issues are significant to social work graduate
students regarding stress and self-care. Furthermore the review of the literature will
provide information on what is currently available.
Student reactions and responses to stress can affect a student in emotional,
cognitive, physiological, and behavioral ways (Misra, McKean, West, & Russo, 2000, as
cited in Robotham, 2008, p.740). What will be provided in this review of the literature
will touch upon some of those issues which affect students. The researcher will center the
literature on five themes. The first theme will be a discussion of some of the symptoms
associated with stress, and will be specifically centered upon physical and psychological
symptoms. It should be noted however, that due to the vast amount of information
available on the symptoms of stress, the researcher has focused on that which is most
relevant to the purpose of this project. The second theme will be centered upon the
concept of eustress. The third theme will focus on stress and its relationship in regard to
9
graduate students. The fourth theme will concentrate on the concepts of burnout and
compassion fatigue. Finally the fifth theme will be on self-care and its importance in
regard to the field of social work. In addition the fifth theme will provide information on
the benefits of self-care and self-care practices.
Symptoms Associated with Stress
Although the causes of stress can be complex there are some commonalties
among the ways that individuals respond to stressors. Some of the more common
reactions to stressors are manifested through both physical and psychological means.
Baum and Posluszny (1999) note that stress is an important bridge between bodily and
mental health because its effects can influence a myriad of responses. The bodily and
behavioral reactions that coexist with stress can be referred to as stress responses (Jones
& Bright, 2001).
When an individual first becomes stressed some biological and psychological
changes begin to occur. In terms of physical changes, increased activity in respiratory and
cardiovascular systems become evident through rapid heartbeat and raised levels of blood
pressure (Baum & Posluszny, 1999). Those responses can eventually be accompanied by
tension, headaches, and other body aches, as well as nausea and anxiety (American
Psychological Association, 2011). These initial responses can be short termed and can
end once the severity of the stressor has been appraised. The process of appraisal is two
part and consists of first recognizing the stressor and second determining how one will
cope with the stressor (Lovallo, 2005). This short termed response which can be referred
10
to as acute stress, it can be temporary and not cause long term effects. Chronic stress
however can have serious health implications.
Chronic stress may include some of the symptoms of acute stress however it
differs from acute stress in the sense that it is consistently present over a period of time
(American Psychological Association, 2011). According to Baum and Posluszny (1999)
the side effects of negative stress specifically those that occur over an extended period of
time are especially taxing on an individual and can be hazardous to health. Research has
shown that chronic stress or stress for that matter has an effect on emotion and mood
which can induce certain disease processes (Johnston, 1997, as cited in Baum &
Posluszny, 1999 p. 143). Prolonged common emotions associated with stress responses
such as anger or distress has been proven to be contributors to coronary diseases and
hypertension (Verrier and Mittleman, 1996).
Stress may also change an individual’s habits and behavior. Specifically sleeping
habits may be affected. Sleep disturbances are a common symptom associated with
stress. If lack of sleep is prolonged over a period of time it may transform into a stressor
(Vgnotzas, Tsigos, Bixler, Stratakis, Zachman, Kales, Vela-Bueno, Chorousos, 1998).
Sleep is a basic need that if disturbed can have implications on individual well being. For
example, lack of sleep interrupts our circadian rhythms which can negatively affect an
individual physically and mentally (Reinberg & Askenazi, 2008). The results of sleep
deprivation can ultimately lead to changes in mood as well as a greater likelihood of
exhaustion and tension (Dinges, Pack, Williams, Gillen, Powell, Ott, Aptowicz & Pack,
11
1997). In addition to affecting sleeping habits, stress can also impact eating habits and
behaviors. It is not rare from people to gain or lose weight during times of distress.
Individuals may over eat or decrease food intake which is dependent upon their reactions
to stressors (Torres & Nowson, 2007). According to Torres and Nowson (1997) when
people are exposed to chronic stress it may induce cravings for high calorie foods which
is a contributor to excess weight gain.
Eustress
There is much discussion on the negative aspects of stress, however that does not
signify that stress is necessarily a completely negative thing. Stress can have some
positive aspects and has been shown to have some beneficial properties. Nelson and
Simmons (2003) note that if stress is managed properly by an individual it can be used to
create positive results (as cited in McGowan, Gardner, & Flecher, 2006, p. 92). These
positive results and feelings from stress can be referred to as eustress. Hans Selye (1975)
was the first to use the term eustress to describe stress that is healthy.
Since Selye the word eustress has been defined in several ways. One very basic
definition of the term which encompasses the meaning of eustress is, “a positive
psychological response to a stressor” (McGowan, et al. 2006, p. 93). As previously stated
there are various responses to stress, some may be more debilitating and negative while
others such as those related to eustress can be beneficial. A positive response that is part
of eustress is that it can be a source of motivation to those who are experiencing stress.
According to Folkman (2008) eustress can provide an individual with motivation and
12
help them find a positive meaning within their problems. Furthermore while under stress
people can be resourceful in problem solving which may in turn provide a feeling of
accomplishment (Folkman, 2008). The motivation that is a part of eustress can be both an
empowering contributor as well as very necessary in the lives of graduate students.
Stress and Graduate Students
Over the years research has shown that regardless of the field of study graduate
students will not complete their education without being confronted with a high degree of
stress (Polson & Nida, 1998). Programs such as social work demand much dedication and
time from a student. In social work graduate programs there are components of research,
classroom instruction, and field training, this combination according to Polson and Nida
(1998) has a tendency to be more stressful than traditional graduate programs.
Having to maintain the dual role of social worker and student may prove to be
challenging to manage and can contribute to changes in stress levels. Robotham (2008)
further supports this idea and even suggests that students who are part of programs that
incorporate clinical training in which the student assumes the role of practitioner, will
experience elevated stress because they have the dual role of practitioner and student.
Dzieglewksi, Marti and Turnage (2004) also add that in addition to the stressors that
come along with being a student, those who are in the helping profession, such as social
work, are faced with additional stressors affiliated with the field and training they must
attain.
13
Stress in general can influence emotional responses and in turn leave an
individual feeling overwhelmed. It is not rare for students to have feelings of being
overwhelmed because it is a common occurrence in the lives of graduate students.
Among what is causing these feelings are both internal and external factors. The findings
of a study by Misra, McKean, West, & Russo (2000) showed that the highest stress levels
experienced by students were attributed to two factors, first outside pressures and
secondly self-imposed stress. Different types of self imposed stress and pressure among
graduate students can be self made deadlines, commitments, and excessive worrying
about uncontrollable factors.
Just as self imposed pressures exist and have an impact, outside stressors also
have a significant impact on graduate student stress levels and feelings. Oswalt and
Riddock (2007) attribute financial strains, balancing multiple roles, and academic
pressure as some leading causes of stress among students. They further suggest that these
factors leave graduate students feeling overwhelmed. In a national college health
assessment the results showed that 85.2% of college students reported feeling
overwhelmed through the year by all the responsibilities and things they had to do
(American College Health Association, 2010). In the same assessment 48.4% of
respondents reported feeling overwhelming anxiety throughout the year (American
College Health Association, 2010). Excessive experiences of being overwhelmed have
the potential to reach the point to where there is trouble managing and coping. Having
14
difficulties coping and managing stress and has been a contributing factor to some
student’s decisions to seek professional help (Oswalt & Riddock, 2007).
There are several sources that stress stems from. In regard to graduate students the
sources of stress can be related to balancing different aspects of life. Offstein, Larson,
McNeill, and Mwale (2004) identified some of the sources of stress among the graduate
student population. Findings showed that graduate students agreed that both competing
demands and internal conflicts where among what caused the most stress. Competing
demands can be defined as, “demands that compete for time, energy and attention”
(Offstein et al., 2004, p. 400). Examples of competing demands that were provided by
graduate students showed that they were caused by some external factors, such as
graduate school requirements, coursework, and relationships with others, especially
family (Offstein, et al., 2004). The same study revealed that these competing demands
often had internal consequences as well which are in the form of internal conflicts. Some
of the internal conflicts described were feelings of having to maintain relationships with
others, having to adjust personal standards, expectations that could not be realized, as
well as guilt (Offstein et al, 2004).
Stress can come from various sources. Its effects can impact the everyday lives of
graduate students and cause significant changes. One of the sources of student stress can
be attributed to increased workload and responsibilities. A study by Ross, Neibling and
Heckert (1999) revealed that 73% of the students in their study felt that increases in their
workload was a main stressor. In addition 73% felt that newly acquired responsibilities
15
that are part of student life contributed to stress (Ross et al., 1999). These sources of
stress influenced changes in some student’s habits. The findings showed that changes in
sleeping patterns was an area which was greatly impacted by stress. Of the participants
89% reported changes in sleeping habits as a source of stress (Ross et al., 1999). In
addition the data showed that 74% of the participants listed changes in eating habits as
being a source of stress (Ross, et al., 1999).
Changes in habits can come about when an individual is experiencing stress.
Specifically changes in health habits have been known to change. The findings of a study
conducted by Hudd, Dumlao, Erdmann, Murray, Phan, Soukas, & Yokozuka (2000)
suggest that stress does in fact have a direct effect on student health habits. Their survey
of 100 college students revealed that when students are stressed they tend to practice
unhealthy habits. The results of the Hudd et al. survey showed that 78.2% of those
students who considered themselves to be stressed reported that frequently ate junk food.
In addition the consumption of junk food the findings showed that alcohol consumption
was common among students, 48.3% of participants drank at least once a week. It was
also apparent in the results that when the participants experienced high levels of stress
they were less likely to exercise.
Procrastination. Thus far there has been discussion of some outside stressors
which contribute to stress. It must be acknowledged however that some amount of stress
can be caused by the individual and only the individual. Procrastination merits mention
due to its prevalence and contributions to stress in graduate student’s lives.
16
Procrastination, specifically delay in academic tasks, is a major contributor to graduate
student stress.
The findings of a study based on the exploring tendencies for student
procrastination, indicated that graduate students were more likely to procrastinate than
undergraduate students (Onwuegbuzie, 1999, as cited in Onwuegbuzie, 2000, p. 103).
Procrastination can result in negative outcomes such as delays which can end up further
complicating situations and even create anxiety (Ellis & Knaus, 1977, as cited in
Onwuegbuzie, 2000, p. 103). Contributors to procrastination can be poor time
management. Planning and management of time can be both productive and alleviate
academic related stress. According to Campbell and Svenson (1992) efficient
management of time and time management related strategies can positively affect a
student by improving academic performance and achievement (as cited in Misra &
McKean, 2000).
Burnout and Compassion Fatigue
Throughout the literature the relationship between stress and burnout has been
apparent. As previously stated by the researcher, social work graduate students have the
dual role of both social worker and student. They are prone to experience both the
burnout due to the strains and pressures of their academic life as well as what they
encounter through their practice in the field. Social work graduate students spend a fair
amount of time at their placements. The Council on Social Work Education (CSWE)
requires as an accreditation standard that at a Master’s level 900 hours of field education
17
must be completed (2010). In sum California State University Sacramento social work
graduate students are required to complete 1,280 hours during their graduate career by the
Division (Sacramento State Division of Social Work, n.d.). Due to the time spent at their
placements graduate students are exposed to some of the issues that come with being a
social worker, a major one being burnout.
The issue of burnout syndrome is common in social work practice. In particular
social workers as a group have been identified as being at risk of experiencing burnout
and stress (Acker, 1999; Egan, 1998; Gilbar, 1998; Sze & Ivker, 1986,; Um & Harrison,
1998, as cited in Lloyd, King, & Chenoweth, 2003, p. 255). Due to the nature of the field
of social work it is not rare for a worker to experience burnout several times during their
career. Organizational structure and working environment play important parts in stress
levels and burnout of those working in the field.
A study by The National Association of Social Workers Center for Workforce
was conducted with the purpose of identifying and gaining insight as to what factors
contribute to excessive stress in the field (Arrington, 2008). The total amount of
respondents (n=3,653) were asked to provide their perspectives on what factors
contribute to work related stress. The results revealed that the respondents felt that they
lacked time to complete their work and that a heavy work load was also responsible for
additional stress. Another stressor that was identified in the study by participants was
having to take on more responsibilities than they could easily manage. Due to social work
being strongly centered on client needs Lloyd, et al. (2002) suggest that social workers
18
are faced with conflicts and difficult situations. It is possible that these difficult situations
over a period of time may take a toll on workers and lead to burnout.
Maslach, one of the leading researchers of burnout syndrome has been quoted
throughout the literature for her definition of burnout. Burnout syndrome, or simply
burnout can be defined as a response which is caused by the buildup of constant,
“emotional and interpersonal stressors” (Maslach, et al., p. 397). Burnout can be the
result of a variety of factors. According to Rigger some of the causes of burnout can be
attributed to the type of work an individual does, relationships with others and
“organizational practices” (Rigger, 2009, p.830).
According to the findings of Riggar (2009) some physical symptoms associated
with burnout can be in the form of, body pain, tension, fatigue, and sleep problems. In
addition emotional and mental indications of burnout are also present. According to
Freudenberger and Richelson (1980) some of the mental and emotional symptoms of
burnout are rigidity, cynicism, impatience, aggression, depression and psychosomatic
complaints. Finally, the symptoms of burnout are also evident within organizational
structures. Turnover, absent and late workers, being dissatisfied with ones job and a
decrease in productivity are some organizational signs and symptoms of burnout (Riggar,
2009). Many of the symptoms of burnout that have been mentioned are also similar or
equal to the symptoms that are part of stress.
Another issue that may result from lack of proper stress management and is often
associated with burnout is compassion fatigue. Compassion fatigue can be defined as,
19
“the formal caregivers reduced capacity or interest in being empathic” (Adams,
Boscarino, & Figley, 2006, p. 103). Like burnout compassion fatigue can affect the
working relationship between a client and a worker. According to McHolm (2006)
compassion fatigue can be the end result of providing high levels of energy as well as
compassion to those who are in distress without seeing the outcomes of positive change
in the individual (as cited in Potter, Deshields, Divanbeigi, Berger, Cipriano, Norris, &
Olsen, 2010, p E57). Compassion fatigue may compromise an individual’s ability to
work with clients effectively as well as function properly within an organization. Like
burnout compassion fatigue has psychological, biological, and organizational symptoms.
Among the symptoms are: trouble sleeping, blaming, a diminished feeling of
accomplishment, and persistent tardiness (Recognizing Compassion Fatigue, 2010).
Self-Care Practices
Social work as well as other professional fields in which human service is the
focus have acknowledged that maintaining personal well being is essential. Since selfcare is seen as being crucial to practitioner health, the concept has been included in
various codes of ethics (Williams, Richardson, Moore, Gambrel, Keeling, 2010). Social
workers as well as students practicing in the field have multiple responsibilities which
may translate to being multiple stressors. These stressors can lead to the previously
mentioned conditions of burnout and compassion fatigue.
Factors such as deadlines, increasing caseloads-some with challenging clients, as
well as the lack of time to accomplish some necessary tasks are common and may be
20
contributors to a shift in personal equilibrium (Whitaker, Weisemiller, & Clark, 2006). In
an NASW issue statement (2008) self-care was described as being a crucial component of
practice and its utilization is vital to coping. In the same issue statement another benefit
of self-care that was given was that it can be a preventive measure used to guard against
and cope with the negative consequences of field (NASW, 2008). They continue to state
that self-care promotes competence and compassion and is an integral part in the
preservation of integrity of the profession of social work (NASW, 2008). Furthermore
there is a call for recognition and inclusion of self-care strategies in social work programs
(NASW, 2008).
There are several definitions of self-care. Gentry (2002) offers perhaps one of the
most basic definitions of self-care which is the, “ability to refill and refuel oneself in
healthy ways” (p.48), while Pincus (2006) defines self-care as “something one does to
improve the sense of subjective well being. How one obtains positive rather than negative
life outcomes” (as cited in Richards, Campenni, & Muse-Burke, 2010, p. 248). Other
definitions may equate self-care with physical activity and or the utilization of outside
sources which promote mental well being. Research has shown that the components that
are likely to be considered part of self-care are related to the mental self, the physical self,
and support (Mahony, 1997, Norcross, 2000, Valente & Marotta, 2005, as cited in
Richards et.al).
Providing different outlets in which to relieve stress is part of the process of selfcare. There are several strategies individuals utilize that could be used to promote well
21
being. Usually strategies focus on meeting the needs of the body and mind. Physical
activity is a common form of self-care that is utilized. There are both specific and general
benefits of using physical activity. According to the Centers for Disease Control and
Prevention (CDC) (2011) the benefits of physical activity is have been known to improve
both mental health and mood. Positive changes in mental health though physical activity
can be specifically measured by the decrease in anxiety and depressive symptoms as well
as in the area of cognition (Callaghan, 2004). Physical activity has overall benefits such
as improvement in health and the quality of life by reducing the development of certain
diseases (Fox, 1999). The CDC (2011) recommends at least two and a half hours of
moderate physical activity per week to increase improvement in health.
Another approach that is utilized for meeting the needs of the body and mind that
is considered to be a form of self-care is mindfulness. Mindfulness is a method that is
centered upon improving individual well being through the practice of meditation. The
approach includes focusing upon breathing and awareness of senses. It is aimed restoring
balance by helping to reduce stress through the connection of thoughts and emotions.
Although not practical for all it has shown to be an effective method for some.
The findings of a study in which master’s level psychology graduate students
utilized mindfulness based stress reduction found that mindfulness did have an impact on
participant well being (Shapiro, Brown, Biegel, 2007). The findings suggested that not
only was it effective in decreasing stress but it was effective in keeping a balanced state
of emotion and lowered repetitive thoughts that the participants had prior to the
22
mindfulness based stress reduction (Shapiro, Brown, Biegel, 2007). One of the ultimate
benefits of mindfulness is that it can help an individual achieve a balance in mood which
can help guard against symptoms of depression (Nolen-Hoeksema, Morrow, &
Frederickson, 1993).
Social support can be an additional resource which is used to provide self-care.
Social support is beneficial because it can reduce stress related emotions such as
depression and anxiety (Skovholt, 2001). Cobb (1995) described it as being important
because it is a way in which an individual can use others as resources. Cobb (1995) goes
on to state that social support can help an individual feel that they are valuable parts of a
network. Social support can come in the form of personal support such as family, friends,
and peers or professional support such as professionals and colleagues. Furthermore these
support systems can be beneficial not only to personal lives but professional lives as well
(Richards et al., 2010).
In regard to the field, professional social support is a factor that contributes to the
sustenance of the professional self. An example of professional social support is seeking
consultation from other colleagues or professionals. Furthermore nurturance came from
venting to those who come from the same environment. In addition this type of support
can decrease adverse reactions which are a result of working in the field. Examples of
adverse reactions which can be a result of the field are the previously mentioned issues of
burnout and compassion fatigue. Another benefit of social support is that it provides a
23
means in which to receive feedback and disclose stressful events which in turn may
reduce stress levels (Barry, Hudley, Kelly, & Cho, 2009).
The feedback one gains from social support can increase their self awareness. The
term self awareness can be considered to be an individual’s state of knowledge about
their actions, their thought processes, and their feelings (Richards et al., 2010). Being in
touch and aware of thoughts, actions, and feelings is an important contributor to
understanding oneself. Maintaining this overall understanding of self can be a contributor
to ethical practice because one is aware of their strengths and faults. Parker J. Palmer
Ph.D. (1998), of University of California at Berkeley, who is an educator, author, and
speaker, wrote about the importance of self understanding, he states, “ The most practical
thing we can achieve in any kind of work is insight into what is happening inside of us as
we do it. The more familiar we are with our inner terrain, the more sure footed our work
and living becomes” (p.5). Therefore increase in self awareness has the potential to
improve certain aspects of life.
Summary
The review of the literature began by examining some of the symptoms associated
with stress. The literature suggests that stress has an impact on areas such as physical and
mental well being. Among them physical manifestations which have been shown to be
related to stress are body pain and tension. In addition disruptions in basic needs such as
sleep and eating have been shown to be impacted by stress.
24
The concept of stress as being a positive force was also examined. Experts such
as Folkman (2008) and Selye (1975) used the term eustress to describe stress that is
healthy. According to the literature some benefits of eustress are that it can be used as a
motivator. Additionally the literature indicates that it can be useful in becoming
resourceful and aid in problem solving.
In regard to graduate students a reoccurring theme that was evident is that stress
has an impact on overall student well being. Researchers such as Polson and Nida (1998)
stated that graduate students are subject to a high degree of stress throughout their college
careers. Specifically the literature showed that social work students are under an
increased amount of stress due to their roles as students working in the field (Robotham,
2008; Dzieglewksi, Marti & Turnage, 2004).
Studies in this review showed that different aspects of student lives are affected
by stress. Both internal and external factors play a role in the stress they experience. New
responsibilities and balancing different roles are both contributors to the development of
stress in students (Misra et al., 2000; Oswalt and Riddock, 2004). A study by Offstein et
al. (2004) found that both competing demands and internal conflicts are sources of stress
for graduate students.
Studies also indicate that habits are also impacted by stress. Diet and sleep were
listed as the habits that were significantly impacted. A study by Hudd et al. (2000)
showed that the changes in habits could be negative. Their study showed that stress had
direct effects on poor diet, exercise habits, and alcohol consumption. Another area of
25
student stress that was included in this review was procrastination and time management.
The literature showed that these were also components of student stress. Furthermore a
study by Onwuegbuzie (1999) showed that graduate students were more likely to
procrastinate than undergraduates.
This literature review also focused on the conditions of burnout and compassion
fatigue. They were both found to be the results of being overly stressed. The literature
showed that those in the helping professions were at a great risk of experiencing both
burnout and compassion fatigue due to the interactions they have in the field (Acker,
1999; Egan, 1998; Gilbar, 1998; Sze & Ivker, 1986,; Um & Harrison, 1998, as cited in
Lloyd, King, & Chenoweth, 2003, p. 255). The literature revealed that many of the
symptoms are indications of stress are the same as the symptoms of burnout and
compassion fatigue.
Finally self-care was also researched. Various disciplines which is based upon
human service, highlight that self-care is an essential part of practice (Williams,
Richardson, Moore, Ganbrel, Keeling, 2010). Specifically NASW (2008) regards selfcare as being vital to coping and prevention of stress. In addition different self-care
practices were covered in this chapter. Among them is a common form which is physical
activity. Research shows that there is evidence of the benefits of physical activity to both
physical and mental wellness (Callaghan, 2004; Fox, 1999).
Mindfulness was shown to be another self-care practice which is useful for some.
There is evidence of links between balance in mood and mindfulness (Wolen-Hoeksema,
26
Morrow, & Frederickson, 1993). Finally what was shown to be an important contributor
to self-care was social support. According to Skovholt (2001) it can be beneficial to
emotional well being. Social support can come from different sources. Two sources
which are listed in this review of the literature are personal and professional support. It
has been found that both types of support can contribute to an increase in self awareness
(Richards et al. 2010).
27
Chapter 3
METHODS
Research Design
The purpose of this study is to record and identify the perceptions and thoughts
regarding both stress and self-care among social work graduate students. The researcher
used a qualitative approach as part of the research design. Since stress and self-care are
dependent upon human experience and are flexible subjects in themselves a qualitative
approach would be fitting and provide a richer understanding of the issue at hand.
Data and Sample
The participants of this study consisted of second year California State University
Sacramento Master of Social Work students. In order to qualify to participate in this
study it was a requirement that the student be enrolled in the second year Master’s of
Social Work program in California State University Sacramento as well as currently be
fulfilling their field education requirements. In addition the demographics of the
participants varied. Participants were of diverse backgrounds, gender and ethnicity in the
attempt to capture the diversity of the students which make up this particular group.
Purposive sampling was utilized in this study to recruit 10 participants. The method used
to recruit the participants was through a list of email addresses which have personally
provided to the researcher by the participant in the past. In addition some of the potential
participants were approached in private. Because there is no formal relationship between
28
the respondents and the researcher, there was no conflict of interest and the respondents
were not coerced to participate in this research.
Measurement Instrument
The researcher obtained data through one time semi structured face to face
interviews in which a questionnaire was utilized (See Appendix B). The questions on the
questionnaire were verbally administrated. A total of 16 questions were asked.
Analysis Plan
In order to analyze the data the audiotapes were replayed in a private setting so that
the researcher could analyze the content of the recorded interviews. During the process of
analysis notes were taken in order to document the similarities and differences among the
participant responses. The researcher selected quotes regarding the participant’s
perceptions on stress and self-care which were also identified and noted. Throughout the
process of analysis the researcher compared the information collected from the
participants to the themes which have been chosen from the literature.
Protection of Human Subjects
Because participant confidentiality is of the utmost importance in this research
concerns regarding confidentiality were addressed. The participants were both presented
a consent form of what they should expect in regard to their protection (see Appendix A).
In addition the information from the consent form was verbalized as well. In order to
further protect the participants they were assured that their identities would be kept
confidential. To further insure the subject’s protection a pseudonym was given to be used
29
when referring to the particular participant throughout the study. The purpose of the
pseudonym is to protect participant identity and ensure confidentiality. The participants
were informed that at any time they may discontinue participation as well as refuse to not
answer any questions they do not feel like answering. After obtaining pertinent
information cassettes and all data including consent forms will also be destroyed.
This study was determined to be a minimal risk study. Protocol was followed and
the informed consent form provided in detail the rights of the participant and what to
expect during the participation process. In addition outside referrals were provided on the
informed consent form in the case that any problems are experienced as a result of
participating in the study (see Appendix A).
30
Chapter 4
FINDINGS
Introduction
The following results are based on ten one time semi structured interviews the
participants are all California State University Sacramento graduate social work students
who are currently fulfilling coursework and practicing in the field. The participants
ranged in age from 24-47. Two males and eight females were interviewed. In terms of
ethnicity there was some variation within the group. The following is based on which
ethnicity they self identified with, the sample was made up of: three Latino participants,
two Caucasian participants, three African American participants, one Asian participant,
and one Native American participant. The purpose of gathering data was to identify the
perceptions and thoughts in regard to stress and self-care as viewed from the perspective
of the participants. The following results are based on the information provided through
the interviews.
Definitions of Stress
The participants were asked to provide their own definitions of stress. What
became apparent to the researcher is that the definitions provided by participants could be
classified in two distinct categories: feelings and thoughts. Five out of the ten respondents
solely equated their definitions of stress to feelings. Their definitions included “feeling
overwhelmed” “feeling anxious” “feeling worried” “feeling pressured”. One participant
31
stated “Stress is a feeling of being uncomfortable and worried which ends up making you
feel overwhelmed” (Participant #6).
In addition four participant’s definitions contained the combination of stress as
being part of thought process and feelings. One respondent stated, “To me stress is when
someone is prohibited from thinking clearly due to being preoccupied with all the
responsibilities and things you have got to do which then ends up turning into negative
feelings that end up making me worried” (Participant #10). Participant # 2 stated, “Stress
is basically this pent up energy and pressure that goes to your mind”. One individual’s
definition was different from the rest; it suggested that stress was attributed to situations
that have the potential to affect functioning. Participant # 9 stated, “Stress is a situation
that causes me to not be able to focus on taking care of my needs”. Another significant
finding is that although they used different language to define the term “stress” from their
perspectives all ten respondents’ definitions related stress to something negative whether
it be a feeling or a thought.
Stress as Motivation
According to the findings, stress serves an important purpose in the lives of these
graduate students. When asked what their perspective on the positive consequences of
stress the findings were significant. All ten respondents believed that stress had some
positive aspects. Each respondent was in agreement that a positive aspect of stress was
that it was a source of motivation. One respondent stated, “To me stress gives me
motivation, my favorite quote is “pressure turns coal into diamonds”. I thrive during the
32
last minute so sometimes stress and pressure are necessary” (Participant #8). Another
participant revealed that the motivation provided by the stress could be beneficial in more
than one way, from his perspective the participant stated:
“Stress can be the ultimate motivator to prepare for a stressful situation or to
avoid a more stressful situation. I think stress benefits us because it tells us that
we need to do something quickly in order to make things better for ourselves”
(Participant #10).
Students have many responsibilities especially when it is related to deadlines and school
related tasks. Four respondents stated that stress was beneficial to them because it helped
them complete tasks on time. One person revealed that “Stress is sometimes the only
motivation I have. If I don’t feel stressed I can feel like I can put it off if I do have that
stress I gotta get it done to alleviate the stress” (Participant # 5). In addition one
respondent stated that often times when she feels a greater sense of accomplishment
when she has completed a task which is motivated by stress than the accomplishment she
would feel if stress was not a motivating factor (Participant #1).
Physical Impact Stress has on Graduate Students
The impact of stress on graduate students affects various aspects of their lives.
What became apparent through data analysis is that stress has an impact on graduate on
the participant’s physical health. Participants were in agreement that physical health was
one of the areas they felt had been affected by stress. Six respondents reported that their
33
sleep has been affected. All six stated that since they began graduate school their sleeping
patterns were directly affected by stress. One participant stated:
“My sleeping patterns and habits have really been impacted by stress. I have
trouble falling asleep and I’m also not getting restful sleep. I notice that I wake up
a lot during the times that I do sleep, which makes me feel ridiculously tired not
just in the morning but throughout the day” (Participant # 5).
Another person stated regarding her sleeping patterns:
“My sleeping has really changed, if I’m lucky I get six hours of sleep and that is
usually because I’ll be staying up late to do assignments or working on my thesis
because I get a feeling at night sometimes that I need to work on things. Also
because I’m stressed I can’t sleep because I start to feel the anxiety” (Participant #
3).
Worrying is what was listed as a reason for having sleep problems four out of six who
revealed that they had issues with sleep stated that they felt worried and it influenced
their ability to get or maintain adequate sleep as well as restful sleep.
Another physical manifestation of stress that was reported was body pain. Four
participants attributed body pain to stress. Headaches, back pain, tension in shoulders,
were all listed as types of pain which the participants attributed to stress. Three
individuals used the term “fatigued” to describe how stress made them feel physically.
Finally weight gain was another response provided. Six individuals reported that they had
34
experienced weight gain as a result of stress and lack of exercise while two stated that
lack of exercise was what had caused the increase in weight. One participant stated:
“My health has been affected most by stress. I gained weight and I think it is
because I tend to overeat when I’m stressed. I noticed how I was feeling and that
even made me more stressed so I decided to make some changes. The stress
actually motivated me to start working out again” (Participant #2).
In this case the participant used stress as a motivator to improve their physical health.
Graduate Students Interpersonal Relationships and Social Life
According to the findings, interpersonal relationships and social lives of these
participants have been directly affected by stress. The results showed that the dynamics
of relationships shifted for some of the participants. In addition there were reports that
some of the social lives of participants have declined in activity. Eight respondents
revealed that there have been significant changes in their social lives. All eight
participants who reported that there have been significant changes in their social life were
in agreement that their social lives were impacted in negative ways. Lack of time and
having new responsibilities were among what were listed as contributing factors.
Respondent # 4 said:
“Once I started graduate school my personal and social life pretty much suffered.
I can’t hang with my friends or go to family gatherings. I will even go weeks
without seeing my family. I usually have some sort of homework or paper to do or
35
if it’s not that it’s usually internship or school related function that keeps me
from doing social things” (Participant #6).
Another person revealed:
“I feel like I’m always saying “no” when people ask me to go out and then I feel
guilty when I do say “no”. So I’m left with that guilt and it makes me feel worse
than I already do. I have so much on my plate that I have even lost interest in
socializing” (Participant #5).
Three participants revealed that their relationships with others have suffered. All
three participants had experienced some loss of relationships. One person said “My
school life and work life has remained somewhat consistent but my personal life was
affected. My relationships with my parents and my partners and my friends all changed,
they were put on hiatus, and some suffered or ended” (Participant #9). From the accounts
of the participants it was evident that they felt strongly about this aspect of their lives
being affected. A participant sternly stated in the interview:
“No one tells you how much it (graduate school) is going to screw up some parts
of your life. You have this idea of what it will be like but the reality is I have no
time for personal relationships and I lost some pretty important relationships
during this whole thing. What’s even worse is that you also begin to feel like you
can’t relate anymore. Unless you’ve been here it’s hard to understand”
(Participant#2).
36
Graduate Students and Issues they Have in the Field Regarding Stress
One of the focuses of the study was to see whether or not stress had an effect on
the participant’s work in the field. The findings showed that three of the participants had
had experiences in which they felt that they and their practice in the field was affected by
stress. One participant in particular stated that she had lost her “drive” at her internship.
She revealed that being overwhelmed had and having a heavy caseload as the culprits.
The participant stated “Honestly, I went through times when I didn’t feel like showing up
I was tired, and I had some days where I wasn’t in the mood to listen to people”
(Participant # 1). Another participant spoke how her practice was affected, she stated:
“I think I had some kind of secondary trauma from some clients. I had to deal not
only with my staff but also outside agencies for a while and I would go home
feeling fatigued and I didn’t want to face my hardest client that I worked with, I
only feel like this once in a while but when I do I dread going (to field)”
(Participant #5).
Finally a participant revealed that they had been a victim of a crime during graduate
school and was confronted with having to work with victims, the participant stated,
“I could not handle it. The accounts given of the victims brought everything to
surface, I hadn’t dealt with it and it was getting in the way of me being able to
help them. I had to use campus psych services to help me”.
37
Finally two of the three participants that said that they felt their practice in the field was
affected by stress said that they had experienced burnout because of their experiences in
the field.
Another significant issue regarding field that was revealed by participants was
related to the amount of days they spent at their internships. Six out of ten participants
felt that interning three days a week during second year added to their stress. Four out of
the six participants stated that so far their final semester had been more difficult because
of the three days spent in field. One participant stated:
“If they (the social work division) wouldn’t have us going to field so much during
this time where we are supposed to be getting important things done that would be
an enormous stress relief, I feel like most of my stress is coming from being at my
placement for three days and then having to shift to school mode” (Participant
#5).
Participant # 2 said,
“I understand that field is really important and I have learned a lot but the three
days coupled with school and thesis has been excessive. I really feel like I could
have gotten a good learning experience from going two days a week. I think the
third day, if anything it made things more difficult to get done”.
Perceptions on the Benefits of Self-Care
A significant finding that was revealed was that all ten participants believe that
self-care had beneficial aspects. In addition all of the definitions of self-care provided by
38
the participants were associated with positive actions that an individual does for
themselves. A participant said, “ Self-care is something that you intentionally plan to do
to calm yourself, especially your body and your mind” (Participant #7). Another
participant related the importance of self-care to an individual and the field, she stated,
“Self-care is essential to minimizing stress. It allows people to be aware of their strengths
and weaknesses and other areas of growth. To me self-care enhances how we behave in
our regular lives and our academic lives and in our practice in the field” (Participant #8).
Finally the data showed that the participants viewed self-care as being a
combination of caring for the body and the mind. The findings showed that there were
three areas that participants perceived would be affected by self-care in a positive way.
Six participants equated self-care as being beneficial to mental well being while five
participants viewed it as being beneficial to physical health. Furthermore four participants
said that self-care improves overall functioning. Finally five participants perceived that
self-care is beneficial to those working in the field.
Types of Self-Care Utilized
When asked what types of self-care the participants utilized findings showed that
they were centered around three main areas. Entertainment, physical wellness, and
mindfulness. To begin, the majority of the participants used entertainment as a form of
self-care. Seven out of ten participants said that entertainment was a main form of selfcare they utilized. Seven participants stated that T.V. was a main source of entertainment.
Other self-care activities that the participants engaged in which were related to
39
entertainment were going to the movies, comedy shows, and video games. A participant
stated, “Watching T.V. is the kind of self-care activity that I do. I enjoy it because it is an
escape that doesn’t require thinking. It takes my mind off of things” (Participant #2).
Listening to music was identified another significant a type of self-care that is used by
this group of graduate students. Six participants said that music was a utilized type of
self-care.
Another type of self-care that is used by participants was focused on physical
wellness. Physical activity was utilized by five of the participants. Two participants stated
that they walk daily while three participants said that they use the gym as a means of selfcare and go regularly. Two participants said that they made changes in their diets and
considered it to be a form of self-care. An additional activity regarding physical wellness
that was used was sleep. Five participants said that sleep is a type of self-care that is used.
A participant said, “I feel sleep deprived a lot of the time, my ultimate kind of self-care is
catching up on sleep, when I can I take naps I do, it helps me recharge” (Participant #6).
Mindfulness was also another form was also practiced by participants. Three
participants revealed that they use meditation as a means of taking care of themselves
mentally. Participant #7 said. “I try and meditate often because for me meditation gives
me a feeling of peace, it also helps me see things more clearly”. Finally prayer was used
identified by two participants as a type of self-care. This was utilized by the least amount
of participants.
40
What was evident from the findings was that when the participants did do some
type of self-care activity they included others. The findings showed that eight individuals
did this. Friends, partners, family members, as well as their peers were included in
participant self-care activities. Another significant finding was that six participants said
that drinking alcohol was included in their self-care activities. Two individuals revealed
that they drink while socializing, while the remaining participants revealed that they
drank with friends, partners and peers only.
Support that Would Minimize Stress
When asked about what type of support would help minimize stress there were
two main types that students felt could help minimize stress, they are social support and
support from the social work department. Social support was the main source listed as
minimizing stress. Seven participants listed peers as a type of support that they think
would minimize stress. Three of the seven who listed peer support suggested that peer
support groups have been beneficial in minimizing stress. One participant stated:
“ What would and has helped minimize my stress has been talking about issues
with my peers. I have been part of a peer support group and I found it was helpful.
Getting together and socializing with my peers helps because we are going
through some of the same exact things. We get to talk about issues and gain
support from one another, it helps to not feel like you’re the only one feeling
stressed all of the time” (Participant #4).
41
Another source of support that participants said helped in regard to minimizing stress was
friends. Seven participants stated that support from friends helps to decrease their stress
levels and are used as an outlet for support. Finally family support was listed by three
participants as being the main form of support that helps them minimize their stress. One
participant said, “From my perspective stress could be minimized by the support of
friends and family, they play a huge role in my life by helping me relax when I am
stressed over simple things” (Participant #10). Another participant stated regarding
family: “For me family support helps me a lot because they are the people I return home
to at the end of the day, they know me and support me better than anybody else”
(Participant #7).
Support from the social work program was the other type of support that the
participants thought would help in minimizing their stress. Four participants felt that the
social work program specifically the office administration could minimize stress.
Organization was what the participants felt the department could improve in. The
participants agreed that better organization on the part of the department could minimize
stress. One participant said:
“I would like it if we got more support from the department admin specifically. I
feel that if they were better organized it would help relieve some of our stress.
They wait until last minute to tell us about deadlines and they are constantly
giving wrong information and it just creates confusion” (Participant #5).
Another participant said regarding support from the department:
42
“Sometimes I feel like the department is not prepared to provide important
information. When we get emails I’m always waiting for the email that is
correcting what was said in the previous emails, it always happens, if that
changed it would be so helpful” (Participant #2).
Finally three participants agreed that more information on stress and coping
should be incorporated in the curriculum and from their perspectives that type of support
would help minimize their stress. One participant stated:
“I think that early in the program and mainly in our practice class, stress and
burnout are introduced as issues that are relevant to our profession, but I think that
even though they are talked about, we are not really shown practical ways of
handling stress. It would make a lot of sense if there was more focus on that”
(Participant #8).
Another person said:
“We work with so many people and we’re taught all these interventions to help
the people we work with, but we don’t really address how to help ourselves in
times of stress. I think our professors are a good source of information and I think
that if there were more information in our courses about this it would be helpful in
minimizing the stress we come across” (Participant #9).
Summary
In this chapter the findings showed that stress is definitely experienced by all
participants in this study. The stress they experienced affected different aspects of their
43
lives as well. In addition the findings showed that the participants viewed that there were
benefits to stress and which they used to their advantage. The findings further showed
that the participants viewed self-care as having beneficial aspects which are related to the
body, mind, and practice in the field. Also the findings showed that the participants did
engage in self-care activities and had recommendations about what types of support
would minimize their stress. Finally field related issues were also present in the data and
even affected functioning in the field for some.
44
Chapter 5
CONCLUSIONS, SUMMARY, RECOMMENDATIONS
Introduction
The purpose of this study was to record and identify the perceptions and thoughts
regarding both stress and self-care among graduate social work students. In addition selfcare and perceptions of self-care, and the role it plays in their lives were explored. This
chapter will include a summary of this study. In addition conclusions will be provided
along with recommendations for future researchers. Finally the implications it has for
social work practice will be addressed as well.
Conclusions
Overall the findings of this study assert the hypothesis of the researcher which is
that social work graduate students experience high levels of stress that affect various
aspects of their lives. All of the participants of this study revealed that they had
experienced an increase in stress levels since they began their studies as graduate
students. Furthermore the researcher noted that one of most interesting findings was that
there was a confirmation that different aspects of participant’s lives were affected by
stress. The areas which were impacted significantly were physical health and
interpersonal relationships and social life. This correlates with the studies of researchers
such as Hudd et al. (2000) and Ross et al. (1999) who highlighted that these areas of
student life were directly affected by stress.
45
The literature suggests that graduate students, especially social work graduate
students, will experience elevated levels of stress throughout their academic careers due
to the training they must attain (Polson & Nida, 1998; Robotham, 2008; Dzieglewski,
Marti, & Turnage, 2004). This was evident through the information provided by the
participants. Some of the participants revealed that the amount of time spent in the field
as well as having to balance the academic aspect of their lives lead to an increase in
stress. This further confirms what the researcher had initially believed to be a
contributing factor to student stress.
One of the most interesting findings of this study was that all participants viewed
stress as having benefits. The study revealed that all of the participants agreed that stress
provided motivation for them, this could be compared with the findings of both Selye
(1975) and Folkman (2008). Both Selye and Folkman related the concept of eustress
(positive stress) as being a source of motivation for individuals. Although all of the
participants viewed stress as having positive benefits all of their definitions equated stress
to being a negative force. It was interesting to see how the participants did not like stress
at certain times but perceived it as being necessary because of its motivating properties
and therefore felt that it was a very helpful.
Another theme that emerged from the findings was support. There were also a
significant number of students who felt that support would be useful in decreasing stress.
The literature reveals that social support is a contributor to self-care and a stress reliever.
Participants listed social support as being their main stress minimizer. Support was also
46
part of self-care practices. Of the participants, eight included others in their self-care
practices. Another significant finding showed that all ten participants perceived self-care
as being beneficial and an important contributor to overall well being. This correlates
with the findings of (Skovholt, 2001). In addition the information given by the
respondents confirmed that graduate social work students do engage in self-care activities
and it does in fact play an important role in their lives. Another interesting finding
regarding self-care was that six participants included alcohol in their self-care practices.
Finally burnout, vicarious, trauma and compassion fatigue were present among
this population. Although the data did not show that there was a very high rate of
individuals who experienced these conditions (3 participants) it was still evident within
the population. The results showed that these issues did in fact have an effect on graduate
student functioning in the field. Finding whether or not stress had an effect on student
functioning in the field this was one of the purposes of this study.
Implications for Social Work Practice
Based on the review of the literature as well as the findings of this study it was
evident that the content of this project is relevant to the field. Insight has been provided
as to which issues affect this population. The population studied in itself is relevant to the
field. The data provided proof that stress does have negative effects on their well being.
This is significant because these individuals are future practitioners and all are currently
working in the field. Clients place their trust and seek assistance from social work
47
graduate students therefore it is crucial that a healthy equilibrium be maintained as a
means to not cause unwanted harm to others and themselves.
The NASW (2008) lists self-care as being an essential part of practice. The
NASW has also described self-care as being a crucial component that if utilized is vital to
coping. Furthermore this topic is significant to the field because self-care can be a
preventive measure used to guard against and cope with the negative consequences of
field (NASW, 2008). In addition both the participants as well as the NASW believe that
there should be more acknowledgement of the importance of self-care and the dangers of
stress. Social work curriculum should include more focus upon these issues among social
work students and practitioners as well due to its prevalence among this population.
Recommendations for Future Researchers
The researcher has some recommendations for future researchers. To begin the
increase in sample size would be ideal. The sample size of this study consisted of only
ten participants which reflect a small fraction of the California State University
Sacramento graduate social work students. An increased number of participants may
prove to increase insight into the issues regarding stress and self-care within this
population. Furthermore more diversity among the sample size would also be ideal,
specifically gender. Although there was an attempt by the researcher to obtain a sample
of participants that was diverse the number of female participants overwhelmed the
number of male participants therefore the researcher recommends an increase in the
amount of male participants in the study.
48
Summary
As mentioned the purpose of this study was record and identify the perceptions and
thoughts regarding both stress and self-care among social work graduate students who are
concurrently fulfilling their field education and coursework. The implications of stress
and its effects on this population were part of the focus of this project and were therefore
explored. In addition self-care and perceptions of self-care of social work graduate
students were analyzed as well. Both the findings from the literature and the data
collected from the participants confirmed that stress has implications on various aspects
of graduate student lives. Just as stress has an impact on graduate social work students the
data showed that self-care does as well. Self-care was viewed as being a crucial part of
practice and a means to take care of one’s body and mind. This was evident in the
literature as well as through the accounts given by the participants. Due to the nature of
the profession of social work stress is unavoidable and expected. Although various
stressors come with being graduate social work students some of the experiences that are
part of the process are very necessary and crucial to the broadening of their knowledge
base.
49
APPENDICES
50
APPENDIX A
Consent to Participate in Research
Stress and Self-Care Among Graduate Social Work Students
Sylia M. Olvera
Division of Social Work
California State University, Sacramento
Hello my name is Sylia Olvera, I am currently a second year graduate student in
the Master’s of Social Work program at California State University Sacramento. As part
of my thesis/project I am conducting a qualitative study which calls for face to face
interviews with second year Master’s of Social Work students. I am inviting you to
participate in my study.
The purpose of this study is to record and identify the perceptions and thoughts
regarding both stress and self-care among second year Master’s of Social Work students.
Furthermore I would like to explore the implications of stress and the effect it has on this
population. I will also explore self-care and perceptions second year social work graduate
students have about self-care, and the role it plays in their lives. Finally I would also
explore if stress and self-care affect their work in field education. If you choose to
participate your experiences and thoughts will provide insight into this topic and help to
answer some of these questions.
During the interview you will be asked questions regarding your personal
thoughts on the topics of stress and self-care which will be recorded using a tape
51
recorder. The face to face interview will be conducted at a location and time which is
convenient for you. Participation in this study is voluntary so if during this process you
wish discontinue participation or refuse to not answer questions you may do so without
any penalty. This interview may take up to an hour of your time. You will not be
compensated for your participation. With your permission a tape recorder will be used
during the interview to record your answers. Please initial here if you agree to be
recorded____.
Because participant confidentiality is of the utmost importance your privacy and
safety will be protected. The consent forms and micro cassette tapes will be stored
separately in envelopes under lock and key in a safe location which only I am aware of. I
will later play the recordings in private in order to collect pertinent information. After
data analysis cassettes and all data including consent forms will also be destroyed upon
completion of my thesis/project. Throughout the study you will be given a pseudonym
which will be used in order to protect your identity. If you experience any problems as a
result of participating in this study you may receive services at the following places:
Sacramento State Campus Counseling and Psychological Services (CAPS) which is
located on the 2nd floor of The Well, Primary Care. Phone number (916) 278-6416.
California State University- Center for Counseling and Diagnostic Services located
in room 421 in Eureka Hall. Phone number (916) 278-6252.
Thank you for your time and participation. If you have any questions, concerns or
comments you may email me at sylia24@hotmail.com or contact me by phone at (XXX)
52
XXX-XXXX. You may also contact my thesis/project advisor Dr. Kisun Nam by email at
kisun.nam@csus.edu or by phone at (916) 278-7069.
By signing this consent form, you are indicating that you fully understand the
above information and agree to participate in this study.
Participant’s Signature:
________________________________
Date: ________
53
APPENDIX B
Interview Questions
What is your definition of stress?
From your perspective, what are the negative consequences of stress?
From your perspective, what are the positive consequences of stress?
Since you began graduate school have you experienced more stress? Please explain
What areas of your life have been affected by stress?
What are some common thoughts you have when you are stressed?
Are you aware of instances where stress could cause you to have physical symptoms? If
so, what were the symptoms?
From your perspective, what type of support would minimize stress?
What else would you like me to know regarding stress?
What is your definition of self-care?
What in your opinion are the benefits of self-care?
What types of self-care do you utilize?
From your perspective, what is considered to be good self-care?
What else would you like me to know regarding self-care?
Can you tell me about a time when you did not want to go to your internship and work
with clients? What was responsible for this?
Does the combination of internship and school cause you to experience more stress?
54
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