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Policy Brief: Violence in the Social Work Profession
Loyola University Chicago School of Social Work
SOWK 602: Health and Behavioral Health Policy and Systems
February 28, 2022
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Dear Senators Tammy Duckworth and Dick Durbin:
Executive summary
The content of this brief covers the ongoing issue of violence that takes place in social service
and healthcare settings across Illinois. Especially among social workers, instances of violence
that happen in the workplace and out in the field threaten the safety and stability of this
profession. This brief will provide an overview of the issue and how that has manifested in a
single case study which had taken place in South Carolina. The findings of the study provide
the harrowing data on the issues social workers have faced while working, and how prepared
they felt to face the challenges. After, there will be a review of two of the most applicable
guidelines and existing policy(s) that are related to protecting social workers on the job and in
the office, and what that entails. The policy in this discussion will touch on funding for the
protection prevention plans needed, and the role that policy plays in addressing this issue. Next,
the brief presents a short discussion of the options for change that are available, and how each
one impacts the implementation of preventative safety measures in health and service settings,
as well as the potential for further development in policy adherence. After that, there will be a
critical analysis of the policy options, and how each plays a part in contributing to safety
measures and information created to protect social workers and other healthcare workers in the
field. Finally, there will be the recommendation of which policy option presents as a critical
component to protecting social workers and a description of why that is the case.
The problem
Given the variety and exposure to several settings that could make social workers vulnerable, it
is important to take into consideration some precautions and trainings that can be done before
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social workers and health professionals venture out into the field. While there are only a few
existing policies and guidelines that give social workers some protection and guidance, this
brief takes a look at some of the gaps that show when experienced in real life. In other words,
the implementation of protective measures and enhanced awareness, understanding, and
training that social workers have access to, prior to, and when working out in the field should
be increased on a material level. Statistics have shown that in 2005, 14.7% of social workers
had experienced a physical assault by their clients, while 30.2% had claimed to have been
assaulted at some time throughout their career as a social worker (Stuck et al., 2014).
The root cause of this violence may be inherent to the work that social workers do, and
can be seen as a manifestation of psychological distress, or heavy resistance to treatment by
clients. This risk and reality of working in social work can be applicable to many of the
different sectors, practices and organizations, and therefore, it is emphasized in the literature,
that organizations should take care to ensure their clinicians are trained with regards to specific
safety procedures and take a variety of precautions within their workspace and without. This
can be done as a part of the licensing process as well.
A study was done in South Carolina which surveyed 554 social workers on their
experiences with violence in their roles as well as the amount of training they received. The
results concluded that 27% of the sample had experienced bullying or harassment within their
workplace, while 44.4% participated in behavior that was unsafe (Guest., 2021). This could
include working alone, without means of contacting another person, or without coworkers
knowing where you are. 32.8% of this sample had experienced verbal assaults or threats, 16%
had experienced physical assault, and 12% witnessed violence in the workplace (Guest., 2021).
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Finally, 69.5% of the sample claimed to have received training to handle violent behavior, but
only 8% stated they were prepared to handle violence they were faced with (Guest., 2021).
These findings implicate that there is little regulation surrounding engagement in safety
training and de-escalation techniques with clients. This could be an effect of ongoing budget
cuts and at times, a lack of resources needed to meet client needs. The four main areas
identified that need to be developed include awareness raising, training, education, and social
work policy and guidelines (Guest., 2021). Safety measures that can be considered include the
arrangement of the clinical office so that the door can be seen from where the social worker
and/or client is sitting, the integration of a panic button, and creating concrete protocols for
managing a threat in the workplace or a field setting (Guest., 2021). The persistent enforcement
of concrete ideas for workplace safety such as safe access to vehicles, mobile phones, risk
assessments for home and field visits, and someone to know where a worker is and when they
are estimated to return is critical, and can make a difference should a violent encounter occur
(Guest., 2021).
Pre-existing Policies
As it stands currently, there are two main pieces that include guidelines from the NASW and
policy S. 4412 named The Protecting Social Workers and Health Professionals from Workplace
Violence Act, that aim to support the protection of social service workers. The NASW
guidelines state that they are meant for development into policy and practice, as well as to
compare against the current workplace safety measures and culture (Newhill & Hagan, 2010).
It specifies that the generalizability of the guidelines developed, should be evolved into
practices and precautions that can be specific across different settings (Newhill & Hagan,
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2010). Encouragement and acknowledgement is made so that regulations, licensing, and
resources are perpetuated by the content of the guidelines to enhance safety for social workers
in their workplace (Newhill & Hagan, 2010).
The guidelines include eleven standards. These standards consist of the organizational
culture of safety and security standard, prevention, office safety, use of safety technology, use
of mobile phones, risk assessments for field visits, transporting clients, comprehensive
reporting practices, post-incident reporting and response, safety training, and student safety
(Newhill & Hagan, 2010). These areas are the most prominent areas that should be considered
when developing workplace safety measures. While the NASW does a great job of considering
and integrating all these factors into workplace safety for social workers, it is clear that the
work to implement this information is needed to adjust the statistics of violent experiences that
are reported by social workers and healthcare workers.
Furthermore, the Protecting Social Workers and Health Professionals from Workplace
Violence Act, lays a solid foundation for the much needed funding of workplace safety
measures for social service organizations. The bill states that they will award grants to states,
Indian tribes, tribal organizations, and urban Indian organizations so that safety measures can
be taken into account and implemented (Sinema, 2022). Some of the features mentioned to be
supported include safety equipment, tracking devices, panic buttons, and locators. Additional
investments might include self defense trainings, security cameras, and learning of deescalation strategies of conflict competency, along with the involvement of law enforcement. In
order to obtain funding, there is an application process and grant writing that goes into it, which
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is required to outline the specific need and developments the organization plans will make
(Sinema, 2022).
Finally, as an existing act in the state of Illinois, the 225 ILCS 20/—Professions,
Occupations, and Business Operations Clinical Social Work and Social Work Practice Act
comes forth as a statute to uphold high standards of the social work profession in our state
(Illinois General Assembly, n.d.). This piece of legislature places a duty upon social workers to
be educated, trained, and qualified to provide quality services as the practice has a strong
impact upon public health, safety, and welfare (Illinois General Assembly, n.d.). We would like
to point out, that just as regulation and importance is placed upon having competent social
workers who can assist all types of people of the public, there should be an equal emphasis on
the safety and implementation of protective measures, that are strictly in place to protect the
welfare of those in the social work profession. This is necessary specifically in our state of
Illinois, in order to carry out consistent and optimal functioning within the social work
profession.
Identification of Options
Both of the presented pieces of formal literature created to protect social workers in the field
pose the framework and provide the resources to bring more safety into the practice. With the
way this information currently stands there are three options. The first is to keep the guidelines
and the policy to protect social workers in place, and maintain the status quo within social work
as it currently stands. This would not be the best option as social workers will continue to
experience the consequences of diminished safety protocols. The second option would be to
consider providing an online or in-person training for social and healthcare workers so that they
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can directly become aware of risk when working out in the field and how to mitigate it. This
option would be favorable in raising awareness and potentially having workers organize a
response that is exclusive to their practice. However, that aspect is not guaranteed. The third and
most supportive option would be to not only implement in-person trainings to learn about risk,
but to also include self defense, in-office safety equipment, assessments, and protocols in place
that organizations are committed to carry out. This third option takes a holistic approach to the
protection of health and social workers.
The point here is that although there is a level of resources available to protect clinicians,
it may be that organizations are overlooking the grant opportunity and NASW guidelines. Every
organization should evaluate the practices that they engage in, and do a risk assessment of the
activities involved. From that point, there can be a better idea of what safety looks like in their
organization and the kinds of tools that are needed to protect workers on home visits, out in the
field, and in the office. These measures may also be built into training for licensing acquisition
and renewal. It may not always be possible that every instance of violence can be prevented, but
the resources available present the opportunity and actions needed to reduce the prevalence of
workplace and field violence in social service and health professions.
Critical Analysis of Policy Options
In 2019, the first official policy to protect health and social service workers was put into place
and this was the Workplace Violence Prevention for Health Care and Social Service Workers Act.
This is the policy that requires health and social service workers to create and employ safety
procedures in the workplace. The literature reads that it took seven years for this bill to pass
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since the reception of its acknowledgement in 2013 (After 7-year effort…, 2022). The statement
made is that prevention plans make workplace violence events more foreseeable. The bill has a
focus towards protecting women who occupy a large amount of the health and social service
workers we see. The bill recognizes workplace safety as a human right and targets employers to
uphold their due diligence in protecting their workplace (After 7-year effort…, 2022). It urges
employers to investigate violence that takes place in the workplace, hazards, and risks as soon as
they are identified. It also protects workers against discrimination and retaliation for reporting
these incidents, and requires employers to keep records of incidents, education, and training that
take place (After 7-year effort…, 2022).
A study from 2016 found that 70% of nonfatal attacks that took place in the workplace
were in health care and social service sectors (After 7-year effort…, 2022). Additionally, the rate
of violence that occurs in health care settings was found to be 12 times the amount of the rates of
these occurrences in other settings(After 7-year effort…, 2022). This bill targets one of the main
stakeholders which is the employer of all health and social service organizations to make sure
that protocols to avoid and curb workplace violence take place (H.R.1309, 2019). They are a
central stakeholder because their facilities and reputation are on the line when these events take
place. Another central stakeholder would be the employees, who’s lives and wellbeing are at
stake in some of these roles. Finally, clients can be seen as a stakeholder, who may be protected
from self inflicted harm by the introduction of this policy.
My Recommendation
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The Workplace Violence Prevention for Health Care and Social Service Workers Act plays a
critical role in the implementation of safety prevention plans, and tools to keep social and
healthcare workers from harm. While the NASW guidelines provide the specific framework for
the safety measures that should be taken, The Protecting Social Workers and Health
Professionals from Workplace Violence Act provides the monetary assistance to states and
organizations who apply for it. This bill was so popular it passed again in May of 2022 with a
higher level of bipartisan support (Following deadly shooting of home health…, 2022). While
this bill and the NASW guidelines are critical to bringing more workplace safety to health and
social service workers, the reinforcement of the Workplace Violence Prevention for Health Care
and Social Service Workers Act is a critical piece of legislation that is on the brink of protecting
many in healthcare, and should be deliberately executed in all social work settings to make it a
safer workplace for all. This bill was passed in the house twice, and was brought to the senate in
May of 2022, where it currently awaits a vote (Following deadly shooting of home health…,
2022). It is my recommendation that this bill become a requirement in all social service
organizations in the state of Illinois, in order to protect social workers from unexpected violence.
That way, we will see required safety measures and practices become implemented in social
work organizations across Illinois—that when recorded and maintained, can serve their purpose
in protecting social workers over time. I hope that following this brief you will better understand
the risk, and strongly support the passing of this bill through the senate when it comes time.
Sincerely,
Illinois Social Workers
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References
After 7-year effort, House votes to pass rep. Courtney's Bill to curb workplace violence against
health care and Social Service Workers. Congressman Joe Courtney. (2022, June 29).
Retrieved February 11, 2023, from https://courtney.house.gov/media-center/pressreleases/after-7-year-effort-house-votes-pass-rep-courtneys-bill-curb-workplace
Following deadly shooting of home health care worker, rep. Courtney urges the Senate to bring
the Bipartisan Workplace Violence Prevention Bill to a vote. Congressman Joe Courtney.
(2022, December 9). Retrieved February 11, 2023, from https://courtney.house.gov/
media-center/press-releases/following-deadly-shooting-home-health-care-worker-repcourtney-urges
Guest, A. (2021, July). Worker protection peer-reviewed social worker safety - ASSP. Retrieved
February 11, 2023, from https://www.assp.org/docs/default-source/psj-articles/
f1guest_0721.pdf?sfvrsn=f9139947_2
H.R.1309 - 116th Congress (2019-2020): Workplace violence prevention ... (2019, November
21). Retrieved February 11, 2023, from https://www.congress.gov/bill/116th-congress/
house-bill/1309
Illinois General Assembly. (n.d.). PROFESSIONS, OCCUPATIONS, AND BUSINESS
OPERATIONS (225 ILCS 20/) Clinical Social Work and Social Work Practice Act.
225 ILCS 20/ clinical social work and social work practice act. Retrieved February 28,
2023, from https://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1295&ChapterID=24
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Newhill, C., & Hagan, L. (2010). Violence in Social Work Practice. Retrieved February 11, 2023,
from https://www.socialworkers.org/assets/secured/documents/sections/mental_health/
newsletters/SEC-NL-26815.MH-NL.pdf
Sinema, K. (2022, June 15). S. 4412. Retrieved February 11, 2023, from https://
www.govinfo.gov/content/pkg/BILLS-117hr2617enr/pdf/BILLS-117hr2617enr.pdf
Stuck, E., Skolnik-Acker, E., Sankar, S., Keaney, B., Fisher, B., Perlstein, J., & Trust, C. (2014,
January 20). Workplace Safety - National Association of Social Workers - NASW-MA.
Retrieved February 11, 2023, from https://www.naswma.org/page/_Test_SafetyLanding