Australian Social Work
ISSN: 0312-407X (Print) 1447-0748 (Online) Journal homepage: https://www.tandfonline.com/loi/rasw20
Building Resilience in Social Workers: An
Exploratory Study on the Impacts of a
Mindfulness-based Intervention
Rachael Crowder & Alexandra Sears
To cite this article: Rachael Crowder & Alexandra Sears (2017) Building Resilience in Social
Workers: An Exploratory Study on the Impacts of a Mindfulness-based Intervention, Australian
Social Work, 70:1, 17-29, DOI: 10.1080/0312407X.2016.1203965
To link to this article: https://doi.org/10.1080/0312407X.2016.1203965
Published online: 03 Aug 2016.
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AUSTRALIAN SOCIAL WORK, 2017
VOL. 70, NO. 1, 17–29
http://dx.doi.org/10.1080/0312407X.2016.1203965
Building Resilience in Social Workers: An Exploratory Study on
the Impacts of a Mindfulness-based Intervention
Rachael Crowder and Alexandra Sears
Faculty of Social Work, University of Calgary, Lethbridge, Alberta, Canada
ABSTRACT
ARTICLE HISTORY
Burnout is a frequent and well-documented consequence of social
work practice. The literature suggests that mindfulness-based
interventions might help develop the mental states and emotional
skills that are indicators of resilience. This mixed-methods, nonrandomised controlled, exploratory study with 14 social workers in
Canada investigated differences in social workers’ levels of stress,
resilience, and burnout after a mindfulness-based intervention,
compared to a waitlist group. The intervention group was also
interviewed about changes in their relationships within the
workplace, their perceived sense of mental health, and wellbeing.
Results suggested that the mindfulness-based intervention
significantly decreased the treatment group’s perceived stress
compared to those on the waitlist and continued to decline for 26
weeks post-intervention. Intervention participants reported
positive changes in attitudes, perspectives, behaviours, and
energy in relation to their workplace relationships with peers and
supervisors. Mindfulness-based interventions for reducing stress
and building resilience to burnout in social workers and other
helping professionals hold promise, and invite further research.
Received 18 July 2014
Accepted 2 May 2016
KEYWORDS
Mindfulness; Resilience;
Stress Reduction; Burnout;
Compassion Fatigue;
Professional Practice
Burnout, compassion fatigue, and other stress outcomes appear to be generally accepted as
consequences of involvement in the social work profession, and their high prevalence
among professionals has been documented (Bride, Radey, & Figley, 2007; Cohen &
Gagin, 2005; Coyle, Edwards, Hannigan, Fothergill, & Burnard, 2005; Lloyd & King, 2004;
Lloyd, King, & Chenoweth, 2002; Radey & Figley, 2007). Burnout refers to a “prolonged
response to chronic emotional and interpersonal stressors on the job, and is defined by
the three dimensions of exhaustion, cynicism, and inefficacy” (Maslach, Schaufeli, &
Leitner, 2001, p. 397). Compassion fatigue as a concept is narrower in scope, and refers to
a unique circumstance in which the practitioner develops trauma-like symptoms in response
to work with traumatised clients (Berzoff & Kita, 2010; Bride et al., 2007). The profound
impact of these stress-related problems warrants an earnest acknowledgement.
Prior studies have reported that among social worker populations, stress-management
training and skills-development programs produced measureable changes in coping skills
and differences in levels of burnout (Cohen & Gagin, 2005; Hirokawa, Yagi, & Miyata,
CONTACT Rachael Crowder
rcrowder@ucalgary.ca
© 2016 Australian Association of Social Workers
18
R. CROWDER AND A. SEARS
2002). However, the research on stress management training programs noted that they
failed to actually reduce stress symptoms (Hirokawa et al., 2002). While the skills development programs resulted in measureable differences in two dimensions of burnout,
they did not reduce emotional exhaustion—a core element of burnout (Cohen & Gagin,
2005; Hirokawa et al., 2002).
What becomes most salient upon immersion in the literature relating to social worker
populations is the divergence between literature on stress reduction and literature on resilience. Although literature on resilience has been well established as it pertains to client
populations—particularly children—enduring traumatic experiences, literature pertaining
to resilience among professional social workers is scant (Collins, 2007). Resilience has been
defined as the ability to adapt to internal and external stressors in a flexible and resourceful
manner (Klohnen, 1996, p. 1067). External stressors are a major consideration in an era of
neo-liberalism and managerialism (Rossiter & Heron, 2011; Trevithick, 2014); nevertheless, the authors do not wish to suggest that social workers “adapt” to oppressive external
environments, and an in-depth discussion of oppressive structural factors and responses is
beyond the scope of this article. However, social workers can build their individual resilience in order to respond to and resist oppressive structures with more cognitive and
emotional clarity. Collins (2007, 2008) reviewed psychological research that suggested
that coping skills, social support, and individual differences all moderate stress, and
suggested that these factors hold promise for predicting resilience among social
workers. Individual differences included reflectiveness, internal locus of control, and optimism and positive emotions, as well as appropriate strategies for problem solving, flexibility, resourcefulness, and active engagement. Grant and Kinman (2012) highlighted
the importance of interventions to improve social worker resilience and suggested mindfulness as one such intervention.
Mindfulness has been defined as “paying attention in a particular way: on purpose, in
the present moment, and non-judgmentally” (Kabat-Zinn, 1994, p. 4). Rooted in Buddhist
philosophy, mindfulness is typically facilitated via the practice of mindfulness (or vipassana) meditation. Mindfulness meditation has been increasingly valued in the psychotherapeutic and medical fields, and decades of research have narrowed the broad field of
mindfulness meditation into brief and accessible mindfulness meditation programs with
the sole aim of stress reduction (Greason & Cashwell, 2009). Mindfulness-Based Stress
Reduction (MBSR) is one such program that has consistently resulted in improved
mental and physical health and a reduction in stress in various patient and professional
populations (Gockel, 2010; Krasner et al., 2009; Shapiro, Astin, Bishop, & Cordova,
2005) and the reduction of burnout in practitioners of related caring professions
(e.g., counsellors, physicians, other health care professionals; Irving, Dobkin, & Park,
2009). However, none have focused solely on building resilience with social work
professionals.
Literature that specifically suggests mindfulness meditation as a method of increasing
social workers’ resilience and wellbeing is slowly expanding. Four reviews examined relevant literature and proposed the potential benefits of mindfulness meditation practice
for clinical social work practitioners (Gockel, 2010; Lynn, 2009; Mishna & Bogo, 2007;
Turner, 2009). Suggested benefits identified in these reviews included increased practitioner skills, affect regulation, resilience, reflectiveness, and wellbeing. Shier and
Graham (2011) interviewed 25 of 646 survey respondents with the highest subjective
AUSTRALIAN SOCIAL WORK
19
wellbeing scores, and these respondents identified mindfulness as an important factor in
their overall sense of wellbeing. However, none of these articles suggested specific interventions to facilitate the achievement of these important goals. The lack of experimental
research on mindfulness-based interventions to increase resilience and reduce burnout,
compassion fatigue, and other stress outcomes on a social worker population presents a
gap in the literature.
Method
This mixed-methods, non-randomised controlled, exploratory study with 14 social
workers in Canada investigated differences in social workers’ levels of resilience and
burnout after an MBSR intervention, compared to a waitlist group.
Purpose
The purpose of this exploratory study was to address this gap by answering the following
questions:
(1) Is there a statistically significant difference in participant social workers’ levels of
decentring and self-compassion (indicating resilience), burnout, perceived stress
and professional quality of life after an MBSR intervention compared to a waitlist
group that receives no MBSR intervention?
(2) If any significant difference exists, is it lasting?
(3) Following intervention, what are the qualitative experiences of the intervention group
of social workers regarding: their relationships within the workplace (e.g., with clients,
coworkers, supervisors); and their perceived level of mental health and sense of
wellbeing?
Participants
Permission to proceed with the research was granted by the university research ethics
review committee and volunteers provided their informed consent to participate in the
research. A poster requesting voluntary participation in a research study investigating
the ameliorating effects of an MBSR program was emailed to all members of the
Alberta College of Social Workers (ACSW). Participants were required to have been
engaged in “front line” or clinical social work practice for a minimum of 3 years, and currently working 20 or more hours a week. Participants had to attend weekly group sessions
and commit to the completion of daily homework. Participants could not already have a
daily mindfulness practice.
Fourteen registered social workers agreed to participate. The sample was composed of 3
males and 11 females ranging in age from 32 to 58 (M = 46.5, SD = 10.17). Ten participants
identified as Caucasian; the remaining 4 identified as Canadian with no further ethnic
description provided. Two participants had a Bachelor of Arts degree, 6 had a Bachelor
of Social Work (BSW) degree and the remaining 6 had obtained a Master of Social
Work (MSW) degree. Social work practice experience ranged from 3 to 34 years
20
R. CROWDER AND A. SEARS
(M = 18.85, SD = 10.08) with the vast majority (over 90%) engaged in micro (individual,
group, family) social work. None had a previous mindfulness meditation practice, but
most practised some form of self-care, typically reported as “exercise”. After the initial
interview and baseline testing with validated scales, individuals were alternately assigned
and evenly divided between the intervention group (n = 7) and the waitlist group (n = 7)
by drawing participant names printed on folded ballots out of a blinded box.
Intervention
Intervention group participants attended one 2.5-hour group session each week for a total
of 8 weekly sessions and attended 1 full-day weekend session between weeks 5 and 6. Each
weekly session began with a brief presentation of that week’s theme followed by guided
experiential exercises related to the theme. The full curriculum did not deviate from a
typical MBSR curriculum (Santorelli & Kabat-Zinn, 2011), and is available upon
request from the first author. Participants were given opportunities to discuss the material
and ask questions, and were given experiential tasks to complete as homework. The facilitator (the primary investigator) was available to consult with participants should any
issues arise prior to the next group session.
Measures
Two brief, semi-structured interviews were completed; the pre-group interview gathered
baseline perceptions, and the second interview followed within 1 week of the end of the
MBSR intervention. Approximately half the interviews were conducted by the primary
investigator and the remainder by a research assistant. Initial interviews were intended
to elicit participants’ thoughts, perceptions, and experiences of burnout. During their
final interview, participants were also asked about any significant positive or negative
changes in their personal and professional lives, including changes in their relationships
with coworkers, supervisors and clients, and any changes in their sense of wellbeing
and mental health. Baseline scales were given to both groups, and the choice of scales
was based on their commonality of use in other mindfulness research and their validity
and reliability.
Perceived Stress Scale (PSS)
The PSS is a commonly used instrument for measuring an individual’s own perception of
his or her stress within the past 10 weeks (Cohen, Kamarck, & Mermelstein, 1983). A 10item scale, the PSS population mean norms are 12.1 (SD = 5.9) for males and 13.7 (SD =
6.6) for females (Cohen & Williamson, 1988). The scale’s concurrent validity has been
demonstrated, and the reliability coefficient has been reported to be .84 to .86 (Lavoie
& Douglas, 2011; Siqueira Reis, Ferreira Hino, & Rodriguez Anez, 2010).
Self-compassion Scale (SCS)
The SCS is positively correlated with a reduction in depression and anxiety and is an indicator of wellbeing and good mental health (Neff, Rude, & Kirkpatrick, 2007). Neff (2003)
effectively demonstrated the 26-item scale’s good construct and content validity, and the
test-retest reliability coefficient was .93.
AUSTRALIAN SOCIAL WORK
21
Experiences Questionnaire (EQ)
The EQ measures decentring, a key factor in resilience and defined as a present-focused
state of acceptance and non-judgment of one’s thoughts and feelings—essentially the
ability to dis-identify with one’s own thoughts. The 20-item EQ has a reliability coefficient
of .83, though test-retest reliability has not been established (Fresco et al., 2007).
Maslach Burnout Inventory (MBI)
Levels of burnout among participants were measured using the 22-item MBI, which has 3
subscales of workplace-related burnout. Reliability coefficients for the MBI subscales have
been reported to be .90 for Emotional Exhaustion, .79 for Depersonalisation, and .71 for
Personal Accomplishment, and data on test-retest reliability has been established to have a
high degree of consistency. The scale has been validated cross-culturally with a variety of
professional populations, including social workers (Maslach & Jackson, 1986; Maslach
et al., 2001).
Professional Quality of Life (ProQOL)
Levels of participants’ compassion fatigue were measured using version 5 of the ProQOL
scale (Stamm, 2009). Scores on three facets of compassion satisfaction and fatigue are
measured by ProQOL: compassion satisfaction, burnout, and secondary traumatic
stress. Each subscale has been reported to have reasonable to high reliability: compassion
satisfaction .87, burnout .72, and secondary traumatic stress .80 (Bride et al., 2007).
Following the baseline validated scales and individual interviews the intervention group
participated in the 8-week MBSR intervention. Immediately post-intervention they completed the same scales and were interviewed again the next week. Scales were readministered at 13 and 26 weeks following the intervention.
The waitlist group did not receive any intervention during the research period, but
completed scales and were interviewed 1 week after the intervention group’s completion
of the intervention, and completed scales again after 13 weeks. Following their completion
of the 13-week scales, the waitlist group also participated in an 8-week MBSR course,
though no data were gathered following course completion.
Data analysis
Quantitative
Independent samples t-tests and Cohen’s d were computed to compare the mean scores of
the intervention and waitlist groups at baseline and at each of the three common intervention stages (pre-intervention, 1 week following, and 13 weeks following). Paired samples
t-tests and Cohen’s d were computed on post-treatment data from both groups at each
stage of measurement (weeks 1 and 13 for both groups, and at week 26 for the intervention
group only). A conservative alpha value (p<.05) was set due to the small sample size.
Qualitative
The audio-recordings of participant interviews were randomly divided between two
research assistants and were transcribed. All transcripts were read twice in entirety by
both investigators, and the content of the intervention group’s final interviews was compiled into one document. The authors decided that the content of the intervention group’s
22
R. CROWDER AND A. SEARS
final interviews would be the most meaningful data in responding to the question, “Following intervention, what are the qualitative experiences of the intervention group of
social workers regarding: their perceived burnout or level of mental health; their relationships with clients, coworkers, and workplace?”
The full qualitative analysis involved two separate processes, one from an emic perspective and the other from an etic perspective, each completed by one investigator, then
reviewed by the other, a method suggested by Rubin and Babbie (2008). The emic
approach starts with inductively coding the interview data from the bottom up, approaching the narrative from the perspectives of the participants as much as possible. This
process is at the heart of grounded theory (Glaser & Strauss, 2009) whereby the researcher
tries to set aside prior assumptions and theories, allowing concepts, patterns, and themes
to emerge. An etic approach is described as top-down, deductive, and starts with concepts,
theories and hypotheses, often gathered from literature reviews or previous research
experience. Post-analyses, both researchers compared each other’s independent analyses,
and agreed that their findings were similar and congruent. Results were pooled and refined
to eliminate redundancies.
Results
Quantitative
Pre-intervention Baseline Scores and Independent Samples t-tests (Table 1)
Baseline scales for both the intervention and waitlist groups revealed that this was a sample
of relatively healthy social workers, with scores for EQ (decentring), SCS (selfcompassion), MBI (Maslach Burnout Inventory), and ProQOL (Professional Quality of
Life) within the normal range. Perceived Stress Scale (PSS) mean scores were on the
high side of normal for both groups. Cronbach’s alpha levels were within the acceptable
range for internal reliability (around .7) for both groups with the exceptions noted in
Table 1. There was no significant difference in baseline pre-treatment mean scores
between the two groups.
PSS mean scores widened significantly between the two groups at 1 week post-intervention
(t(12) = −2.61, p = .02, two-tailed) with a large effect size (d = 1.39): the intervention
group’s perceived stress mean score decreased and the waitlist group mean score
increased. At week 13 the difference between the groups was no longer significant.
There were no other between-group differences on the variables at the 1-week and
13-week follow-up time points.
Intervention Group Post-intervention Paired Samples t-tests and Effect Sizes
(Table 2)
Results at 1 week following the intervention revealed that the differences between pre- and
post-intervention means were significant for the EQ (t(4) = 4.06, p = .01, one-tailed) with a
large effect size (d = 1.8) and the SCS [t(5) = 2.81, p = .02, one-tailed] with a large effect size
(d = 1.2). Significant differences in pre- and post-scores for the EQ and SCS were maintained when retested at 13 weeks (EQ t(4) = 4.56, p = .01, one-tailed with a large effect
size d = 2; SCS t(6) = 2.66, p = .02, one-tailed with a large effect size d = 1) and 26
weeks (EQ t(4) = 3.52, p = .01, one-tailed, with a large effect size d = 1.6; SCS t(6) = 4.07,
AUSTRALIAN SOCIAL WORK
23
Table 1 Baseline and post-treatment means (M ), standard deviations (SD), independent samples t-tests,
and effect sizes
Treatment
Variable
Baseline
EQ
SCS
PSS
MBI.PA
MBI.EE
MBI.DP
QOLCom
QOLBur
QOLTra
Post 1 Week
EQ
SCS
PSS
MBI.PA
MBI.EE
MBI.DP
QOLCom
QOLBur
QOLTra
Post 13 weeks
EQ
SCS
PSS
MBI.PA
MBI.EE
MBI.DP
QOLCom
QOLBur
QOLTra
Waitlist
t-test
n
M
SD
n
M
SD
t
df
p
5
7
7
5
5
5
7
7
7
34.20
2.96
17.43
38.20
22.20
4.00
37.00
23.29
19.00
3.35
0.71
5.13
5.50
8.59
3.08
8.83
4.31
3.70
7
7
7
7
7
7
7
7
7
35.57
3.02
18.86
36.14
26.57
6.57
40.14
25.00
21.14
2.70
0.74
5.67
6.44
14.41
5.44
5.98
7.37
5.73
−0.79
−0.17
−0.49
0.58
−0.60
−0.95
−0.78
−0.53
−0.83
10
12
12
10
10
10
12
12
12
0.45
0.87
0.63
0.58
0.56
0.37
0.45
0.61
0.42
5
7
7
5
5
5
7
7
7
39.57
3.76
14.00
42.40
17.80
4.40
42.00
21.33
20.33
3.46
0.29
3.61
2.88
8.04
4.39
4.52
4.37
4.41
7
6
7
7
7
7
7
7
7
37.57
3.35
20.00
34.14
23.57
5.71
38.86
23.57
21.43
3.46
0.47
4.90
15.00
11.65
4.39
6.47
5.13
6.24
1.08
1.84
−2.61
1.20
−0.95
−0.05
1.00
−0.84
−0.34
12
10
12
10
10
10
11
11
11
0.30
0.10
0.02*
0.26
0.36
0.62
0.34
0.42
0.73
5
7
7
5
5
5
7
7
7
39.43
3.51
11.14
38.14
17.71
4.71
41.00
21.71
19.29
3.41
0.76
3.90
6.69
6.24
3.99
6.30
4.72
2.98
7
7
7
7
7
7
7
7
7
37.43
3.28
15.43
36.86
21.43
4.86
40.86
21.29
19.71
3.64
0.59
5.29
4.30
10.88
3.63
7.43
6.29
3.90
1.06
0.64
−1.73
0.43
−0.78
−0.07
0.04
0.14
−0.23
12
12
12
12
12
12
12
12
12
0.31
0.53
0.11
0.68
0.45
0.95
0.97
0.89
0.82
Cohen’s
d
1.39a
Note. EQ = Experiences Questionnaire; SCS = Self-compassion Scale; PSS = Perceived Stress Scale. MBI = Maslach Burnout
Inventory: PA = Personal Accomplishment; EE = Emotional Exhaustion; DP = Depersonalisation ProQOL = Professional
Quality of Life Scale: Com = Compassion satisfaction; Bur = Burnout; Tra = Secondary traumatic stress.
a
Denotes high clinical/practical significance using Cohen’s d for treatment effect: effect size 0–0.19 = no effect; 0.2–0.49 =
small effect; 0.5–0.79 = medium effect; 0.8 and above = large effect.
*Denotes statistical significance. Baseline t-tests alpha level .05, two-tailed. Post-treatment t-test alpha level .05, one-tailed.
p = .01, one-tailed, with a large effect size d = 1.5). By week 13 the intervention group’s PSS
mean score had decreased significantly (t(6) = −2.98, p = .01, one-tailed) with a large effect
size (d = 1.6) from the pre-intervention mean score and maintained significance at week
26 (t(6) = −3.38, p = .01, one-tailed) with a large effect size (d = 1.3). In addition, by
week 13 the intervention group presented a significant difference within the ProQOL subscale Compassion Satisfaction (t(6) = 1.97, p = .049, one-tailed) with a medium effect size
(d = .74), which remained significant at week 26 (t(6) = 4.24, p = .03, one-tailed) with a large
effect size (1.6). The ProQOL mean score for Burnout showed a significant decrease by
week 26 (t(6) = −2.63, p = .02, one-tailed) with a large effect size (d = .99).
Waitlist Group Post-intervention Paired Samples t-tests
There was a statistically significant decrease in the mean score for ProQOL Burnout in
the waitlist group at week 13 (t(6) = −2.81, p = .031, one-tailed) with a large effect size
(d = 1.06) compared to baseline score. There were no significant results at either the
week 1 or week 13 follow-up time points compared to baseline among the other key
variables.
24
R. CROWDER AND A. SEARS
Table 2 Post-intervention paired samples t-tests and effect sizes for treatment group
Week 1
t-test
Variable
Mdif
SD
t
df
p
EQ
SCS
PS
MBI.PA
MBI.EE
MBI.DP
PQ.Com
PQ.Bur
PQ.Tra
5.2
0.68
−3.43
3.5
−7.75
0.75
2.17
−1
1.33
2.86
0.59
7.35
4.93
10.66
3.59
4.36
4.98
7.66
4.06
2.81
−1.24
1.42
−1.45
0.42
1.22
−0.49
0.43
4
5
6
3
3
3
5
5
5
.01*
.02*
0.13
0.13
0.13
0.35
0.14
0.32
0.34
Cohen’s
d
1.8a
1.2a
Week 13
t-test
Mdif
SD
t
df
p
5
0.55
−6.29
1.2
−6
0.2
4
−1.57
0.29
2.45
0.55
3.89
6.61
7.04
2.28
5.39
4.2
5.12
4.56
2.66
−2.98
0.41
−1.91
0.2
1.97
−0.99
0.15
4
6
6
4
4
4
6
6
6
.01*
.02*
.01*
0.35
0.06
0.42
.049*
0.18
0.44
Cohen’s
d
2a
1a
1.6a
0.74
Week 26
t-test
Mdif
SD
t
df
p
8.2
0.72
−7
1.4
−10
−1.4
5.57
−2.42
−1.43
5.21
0.47
5.48
8.44
12.15
3.97
3.46
2.44
6.55
3.52
4.07
−3.38
0.37
−1.84
0.79
4.24
−2.63
−0.58
4
6
6
4
4
4
6
6
6
.01*
.01*
.01*
0.37
0.07
0.24
.03*
.02*
0.29
Cohen’s
d
1.6a
1.5a
1.3a
1.6a
.99a
Note. All differences (M dif) are from subtracting post-treatment means from pre-treatment mean. EQ = Experiences Questionnaire; SCS = Self-compassion Scale; PSS = Perceived Stress Scale.
MBI = Maslach Burnout Inventory: PA = Personal Accomplishment; EE = Emotional Exhaustion; DP = Depersonalisation. PQ = Professional Quality of Life Scale: Com = Compassion satisfaction;
Bur = Burnout; Tra = Secondary traumatic stress
a
Denotes high clinical/practical significance using Cohen’s d for effect size: 0–0.19 = no effect; 0.2–0.49 = small effect; 0.5–0.79 = medium effect; 0.8 and above = large effect.
*Denotes statistical significance at the .05 level, one-tailed.
AUSTRALIAN SOCIAL WORK
25
Qualitative
Post-intervention interview data revealed that participants in the MBSR program did not
perceive themselves as burnt out, felt they were better able to handle stress, and had a sense
of renewed energy, wellbeing, and hopefulness. From these post-intervention narratives
three major themes emerged: changes in attitude or perspective, changes in behaviour,
and changes in energy levels.
Changes in Attitude or Perspective
“My outlook is a much more hopeful one”, said one participant, “and in some regards it’s
kind of a more detached one—which to my way of thinking lends itself to greater hope,
because you don’t personalise things quite so much.” Participants reported an increased
ability to let go of or reframe negative thoughts, and to self-regulate emotions when
dealing with coworkers and managers. One participant stated:
Some of the distressing thoughts that occur for you, they’re just thoughts, you don’t have to
be attached to them, you don’t have to react to them, you don’t have to have the emotions
about them, or the memories about them.
Participants also felt more present with clients, were able to engage in deeper listening, and
expressed a greater sense of hope for clients with persistent mental health issues or oppressive life circumstances. Participants noted their increased skill in dealing effectively with
personal and professional stressors; as one said, “I’m able to deconstruct some of the
issues that present and not get so emotionally high or low because of the content but
rather just peacefully attend to the issues.” Another reflected, “Even when I’m working
with people who get caught up in the negative, I find that I search for the positive, and
I can also set boundaries when people are just not willing to let go of the hopelessness.”
One participant confided that he no longer felt trapped, and that he now had a sense of
liberation and the freedom to choose:
I’m on a better track … I don’t feel trapped, where before I used to … Well I have more space
in my head (laughs) in the fact that I can, I can choose … I recognize that … I can get pulled
into the dark side of the idea of burnout and feel like I’m hopeless. And now I feel like I have
choices, that I recognize what takes me down that path, and that I can be different about how
I go, and not go down that path.
One woman’s comment on how much more self-compassionate she had become as a
result of being introduced to mindfulness was typical for this group: “My level of mindfulness regarding myself has increased and at first I went through a real loving kindness
type of process, and right now I still have that with me.”
Changes in Behaviour
Several commented on additional physical health benefits they were experiencing, including improved sleep, feeling calmer, healthier eating habits, and feeling more connected to
the body—“I’m … eating wise and therefore everything falls into place for me, I feel healthier, I’m breathing better”—motivating changes in personal and professional lifestyles.
Many mentioned that they were making better choices, particularly around work habits
and caseloads, as they were more aware of their own emotional and physical fatigue
26
R. CROWDER AND A. SEARS
levels and the need for rest and exercise breaks, suggesting a more self-compassionate
awareness of their personal wellbeing.
Changes in Energy
Most participants expressed the desire to continue with the mindfulness practices postintervention because they recognised and valued the tangible health benefits and the
increased sense of wellbeing, energy, and balance. Typical statements that illustrate this
positive change in personal and professional energy include “I found that … I have
more energy”, and “so I think I have more energy to hear and understand where
(clients) are coming from”.
Discussion
The purpose of this exploratory study was to address a gap in the existing research through
the investigation of a mindfulness-based intervention, and the variables of resilience (as
measured by self-compassion and decentring), burnout, compassion fatigue, and other
stress outcomes among a professional social worker population, as well as their qualitative
experiences post-intervention on their sense of personal wellbeing and workplace-based
relationships. This was the first time a trial of MBSR was conducted among social
workers to build workplace resilience.
There was only one variable at one time point, Perceived Stress at week 1, for which
there was a significant difference between the intervention group and the waitlist group.
While there were no other between-group differences at any other time point, the raw Perceived Stress scores continued to lower at 13 and 26 weeks for the intervention group.
Cohen et al. (1983) stated that the PSS is more about one’s relationship to stressful
events rather than the “factuality” of the event(s) themselves. Therefore, the reported
reduction in stress immediately following the MBSR intervention suggested that the perceived reduction was a result of the intervention itself rather than changing external
events, and that continued mindfulness practice was successful in helping the social
workers maintain a balanced perspective about stressors in the longer term. The qualitative data also suggested that participant interviews consistently referred to the beneficial
changes in thoughts, emotions, and behaviours that resulted from a new way of perceiving,
which they attributed to the mindfulness training, and their continued home practice
beyond the intervention.
Because of the size of the study, no efficacy of the group intervention can be reliably
claimed and much less weight can be placed on the within-group differences. However,
trials that fail to demonstrate efficacy are still important to publish and it may also be
argued that since this is such a small trial the non-significant results may be a product
of the study being underpowered. Results show some initial promise, but will need to
be tested further in a future trial. Furthermore, the within-group changes juxtaposed
with the interview narratives provide additional value and insight.
The post-intervention EQ paired samples t-test results suggested that the intervention
group gained a significantly increased ability to “decentre” or to “re-perceive,” meaning
that they “identify less with the content of mental events (thoughts and emotions) and
more with the awareness of those events” (Orzech, Shapiro, Brown, & McKay, 2009,
p. 213). The participant narratives also suggested that they developed the skill of
AUSTRALIAN SOCIAL WORK
27
decentring, essentially the ability to dis-identify with one’s own thoughts and emotions
hypothesised to be a predictive factor for resilience (Fresco et al., 2007).
Self-compassion Scale (SCS) (Neff, 2003) mean scores also increased significantly, and
held their significance when retested at weeks 13 and 26. This increased score suggested
that individuals reported an improvement in the three constructs of self-kindness,
common humanity, and mindfulness, and a complementary decrease in the constructs
of self-judgement, isolation, and over-identification with negative thoughts. The qualitative data also supported this finding; participants spoke about feeling kinder towards themselves, and making different choices around life-and-work balance so as to treat
themselves with greater compassion. Self-compassion is positively correlated with a
reduction in depression and anxiety (Neff et al., 2007). Participants in the intervention
group experienced a reduced risk for developing burnout and improved satisfaction in
their role as a helping professional along two ProQOL subscales (Stamm, 2009). Participants expressed this in the interviews as feeling more hopeful, and being more present
with clients without being so personally affected by their clients’ suffering.
Limitations
There were several limitations to this exploratory research. The small, non-representative
convenience sample increases the risk of sampling error and precludes generalisation, and
the conservative p value set at <.05 increased the chance of a Type II error. The selfselected volunteers may already have had a positive bias towards the topic of mindfulness
that influenced their reporting. Study design was problematic because participants were
not blind to the motive of the research, and so may consciously or unconsciously have
desired to report a reduction in stress. Further, because the facilitator of the intervention
was also the lead researcher, this gave participants comfort and familiarity with her. While
this fact also may have facilitated any success of the intervention, it may have created a
desire within participants to report a reduction of stress. This is particularly important
to note when considering the content of the final intervention group interviews, as
some participants reported to the same person who had attempted to help them for a
period of 8 weeks (Shanafelt, 2009). These findings warrant further investigation with a
blinded study with larger numbers of more diverse participants. Measures that do not
rely on self-reporting (e.g., client session rating scales) and tools that measure other constructs predictive of resilience, (e.g., empathy, as suggested by Kinman & Grant, 2011)
could also add value to future research.
Conclusion
MBSR appears to be a promising approach in reducing stress in social workers and
strengthening resilience through increasing self-compassion and the ability to decentre,
and by reducing perceived stress, compassion fatigue, and risk of burnout. Participant narratives suggested that as a result of participating in the MBSR program they experienced
an improved ability to relate to coworkers, managers, and clients in a more mindful,
embodied way; it gave them more hope when faced with difficulties, and improved
their physical and mental wellbeing. This exploratory research encourages us to confirm
these preliminary findings by repeating this study with a larger representative sample
28
R. CROWDER AND A. SEARS
over a longer time period with the goal of providing an effective intervention aimed at protecting and strengthening personal and professional wellbeing among social workers.
Disclosure statement
No potential conflict of interest was reported by the authors.
Funding
Funding for this study was provided by a seed grant from the University of Calgary Research Grants
Committee.
References
Berzoff, J., & Kita, E. (2010). Compassion fatigue and countertransference: Two different concepts.
Clinical Social Work Journal, 38, 341–349.
Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work
Journal, 35, 155–163. doi:10.1007/s10615-007-0091-7
Cohen, M., & Gagin, R. (2005). Can skill-development training alleviate Burnout in hospital social
workers? Social Work in Health Care, 40(4). doi:10.1300/J010v40n04_05
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of
Health and Social Behavior, 24, 385–396.
Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the United States. In
S. Spacapan, & S. Oskamp (Eds.), The Social Psychology of Health. Newbury Park, CA: Sage.
Collins, S. (2007). Social workers, resilience, positive emotions and optimism. Practice: Social Work
in Action, 19(4), 255–269. doi:10.1080/09503150701728186
CollinsS. (2008). Statutory social workers: Stress, job satisfaction, coping, social support and individual differences. British Journal of Social Work, 38, 1173–1193. doi:10.1093/bjsw/bcm047
Coyle, D., Edwards, D., Hannigan, B., Fothergill, A., & Burnard, P. (2005). A systematic review of
stress among mental health social workers. International Social Work, 48(2), 201–211. doi:10.
1177/0020872805050492
Fresco, D. M., Moore, M. T., van-Dulmen, M. H. M., Segal, Z. V., Ma, S. H., Teasdale, J. D., &
Williams, J. M. (2007). Initial psychometric properties of the experiences questionnaire:
Validation of a self-report measure of decentering. Behavior Therapy, 38, 234–246.
Glaser, B. G., & Strauss, A. L. (2009). The discovery of grounded theory: Strategies for qualitative
research (4th ed.). Piscataway, NJ: Transaction.
Gockel, A. (2010). The promise of mindfulness for clinical practice education. Smith College Studies
in Social Work, 80, 248–268.
Grant, L., & Kinman, G. (2012). Enhancing wellbeing in social work students: Building resilience in
the next generation. Social Work Education: The International Journal, 31(5), 605–621. doi:10.
1080/02615479.2011.590931
Greason, P. B., & Cashwell, C. S. (2009). Mindfulness and counseling self-efficacy: The mediating
role of attention and empathy. Counselor Education and Supervision, 49, 2–19.
Hirokawa, K., Yagi, A., & Miyata, Y. (2002). An examination of the effects of stress management for
Japanese college students of social work. International Journal of Stress Management, 9(2), 113–123.
Irving, J. A., Dobkin, P. L., & Park, J. (2009). Cultivating mindfulness in health care professionals: A
review of the empirical studies of mindfulness-based stress reduction (MBSR). Complementary
Therapies in Clinical Practice, 15, 61–66. doi:10.1016/j.ctcp.2009.01.002
Kabat-Zinn, J. (1994). Wherever you go there you are: Mindfulness meditation in everyday life.
New York: Hyperion.
Kinman, G., & Grant, L. (2011). Exploring stress resilience in trainee social workers: The role of
emotional and social competencies. British Journal of Social Work, 41, 261–275. doi:10.1093/
bjsw/bcq088
AUSTRALIAN SOCIAL WORK
29
Klohnen, E. C. (1996). Conceptual analysis and measurement of the construct of ego-resiliency.
Journal of Personality and Social Psychology, 70(5), 1067–1079.
Krasner, M. S., Epstein, R. M., Beckman, H., Suchman, A. L., Chapman, B., Mooney, C. J., & Quill,
T. E. (2009). Association of an educational program in mindful communication with burnout,
empathy, and attitudes among primary care physicians. Journal of the American Medical
Association, 302(12), 1284–1293. doi:10.1001/jama.2009.1384
Lavoie, J. A., & Douglas, K. S. (2011). The perceived stress scale: Evaluating configural, metric and
scalar invariance across mental health status and gender. Journal of Psychopathology and
Behavioral Assessment, 34(1), 48–57. doi:10.1007/s10862-011-9266-1
Lloyd, C., & King, R. (2004). A survey of burnout among Australian mental health occupational
therapists and social workers. Social Psychiatry and Psychiatric Epidemiology, 39(9), 752–757.
doi:10.1007/s00127-004-0808-7
Lloyd, C., King, R., & Chenoweth, L. (2002). Social work, stress and burnout: A review. Journal of
Mental Health, 11(3), 255–265.
Lynn, R. (2009). Mindfulness in social work education. Social Work Education: The International
Journal, 29(3), 289–304.
Maslach, C., & Jackson, S. E. (1986). Maslach burnout inventory: Manual. Palo Alto, CA:
Consulting Pychologists Press.
Maslach, C., Schaufeli, W. B., & Leitner, M. P. (2001). Job burnout. Annual Review of Psychology, 52,
397–422.
Mishna, F., & Bogo, M. (2007). Reflective practice in contemporary social work classrooms. Journal
of Social Work Education, 43(3), 529–544.
Neff, K. (2003). The development and validation of a scale to measure self-compassion. Self and
Identity, 2(3), 223–250.
Neff, K., Rude, S. S., & Kirkpatrick, K. L. (2007). An examination of self-compassion in relation to
positive psychological functioning and personality traits. Journal of Research in Personality, 41
(4), 908–916.
Orzech, K. M., Shapiro, S. L., Brown, K. W., & McKay, M. (2009). Intensive mindfulness trainingrelated changes in cognitive and emotional experience. The Journal of Positive Psychology, 4(3),
212–222.
Radey, M., & Figley, C. R. (2007). The social psychology of compassion. Clinical Social Work
Journal, 35, 207–214. doi:10.1007/s10615-007-0087-3
Rossiter, A., & Heron, B. (2011). Neoliberalism, competencies, and the devaluing of social work
practice. Canadian Social Work Review/Revue canadienne de service social, 28(2), 305–309.
Rubin, A., & Babbie, E. (2008). Research methods for social work. Belmont, CA: Thompson Brooks/
Cole.
Santorelli, S. F., & Kabat-Zinn, J. (Eds.). (2011). Center for mindfulness professional education and
training resource manual (2011 ed.). Worcester, MA: Center for Mindfulness.
Shanafelt, T. D. (2009). Enhancing meaning in work: A prescription for preventing physician
burnout and promoting patient-centered care. Journal of the American Medical Association,
302(12), 1338–1340. doi:10.1001/jama.2009.1385
Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness based stress reduction
for health care professionals: Results from a randomized trial. International Journal of Stress
Management, 12(2), 164–176.
Shier, M. L., & Graham, J. R. (2011). Mindfulness, subjective well-being, and social work: Insight
into their interconnection from social work practitioners. Social Work Education: The
International Journal, 30(1), 29–44.
Siqueira Reis, R., Ferreira Hino, A. A., & Rodriguez Anez, C. R. (2010). Perceived stress scale:
Reliability and validity study in Brazil. Journal of Health Psychology, 15, 107–114.
Stamm, B. H. (2009). The concise ProQOL manual. proqol.org.
Trevithick, P. (2014). Humanising managerialism: Reclaiming emotional reasoning, intuition, the
relationship, and knowledge and skills in social work. Journal of Social Work Practice, 28(3),
287–311.
Turner, K. (2009). Mindfulness: The present moment in clinical social work. Clinical Social Work
Journal, 37, 95–103.