Social Work News

Self-Care: An Imperative

February 3, 2020

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J.Jay Miller, Erlene Grise-Owens

Social Work, Volume 65, Issue 1, January 2020, Pages 5-9, https://doi.org/10.1093/sw/swz049

15 December 2019

This special issue seeks to deepen the social work profession’s conceptualization of self-care and promote effective implementation of self-care in professional practice. The coeditors and contributors advocate for self-care as an essential element of ethical professional practice. As the call for papers stated, “Self-care affects a myriad of aspects of social work practice, such as staff morale, professional accountability, ethical conduct, burnout, and ultimately the health of our organizations and the profession itself.

Self-Care as Core Professional Practice

In the last few years, self-care has become somewhat of a buzzword. This buzz is certainly an improvement from the previous void in recognizing the need for self-care. Having worked for over a decade to raise awareness about self-care, we (the coeditors) do not want to dismiss the value of a buzz, which creates much-needed initial awareness. However, this buzz can become problematic if the initial understanding of self-care is not expanded and taken as a serious professional commitment—not just an optional add-on or superficial fad.

In 2009, the National Association of Social Workers (NASW) issued a policy statement titled “Professional Self-Care and Social Work.” This statement should be required reading for every social work student, and it should be reviewed and reinforced routinely by all practitioners. Furthermore, this statement needs to be taken even more seriously and put into practice by the profession, at large, through much more explicit, integrated, and intentional ways. This statement—crafted a little over a decade ago—serves as a useful framework for our editorial’s critical reflection. How well is the social work profession practicing self-care, that is, carrying out this NASW directive? And, moving forward, how do we more effectively fulfill the increasingly crucial aims set forth in this statement?

Succinctly, the statement lays out the rationale for self-care as “an essential underpinning to best practice in the profession of social work . . . [and] is critical to the survival and growth of the profession” (NASW 2009, p. 268). Then, the document lays out 11 specific suggestions for the profession. These crucial suggestions can be categorized as self-care (a) in the organizational context, (b) as core professional practice, and (c) as integral to initial socialization and ongoing practice for the profession. The statement’s final suggestion emphasizes the compelling need for continued research on self-care.

Self-Care in the Organizational Context

The first two suggestions in the policy statement emphasize the role and responsibility of organizations to implement policies, procedures, and programs that promote wellness cultures. The third and fourth items call for supervisors and administrators to model, support, and promote self-care. This attention to the macro context is crucial. Certainly, as research documents and practice wisdom underscores, supervisors and administrators play key roles in affecting employees’ well-being (for example, Cox & Steiner 2013) Practitioner well-being affects practice effectiveness. Helping leaders be positive role models and supporters of employees’ self-care is an important dimension that needs to be developed in the profession’s culture.

Similarly, organizations need to be much more intentional and dedicated to creating and sustaining effective wellness cultures (for example, Kanter & Sherman 2017) Too often, these organizational efforts are “Band-Aid” approaches, haphazard efforts, and ineffectual short-term checklists. Similar to how practitioners too often approach individual self-care, organizations frequently view organizational wellness as an add-on and superficial fix. Organizations need readily accessible and practical resources, models, and frameworks to inform them in how to affect crucial, multifaceted, sustainable change toward a culture of wellness.

Critically, we see an emerging problematic dissonance created by the framing and false dichotomy of organizational wellness and practitioner self-care. This framing and false dichotomy needs to be recognized and explicitly addressed. These concepts—that is, self-care and organizational wellness—are often used interchangeably, which creates problems in both conceptualization and implementation. To clarify, organizational wellness is distinctive from self-care in that it focuses on the larger system’s role in employee well-being. In contrast—and complementarity—self-care is the purview of the individual practitioner to affect their own well-being.

One way this problematic framing and either/or fallacy plays out is when organizational leaders fail to recognize their role and place all responsibility on employees for their own well-being. Likewise, however, this problematic framing is expressed when individual practitioners abdicate or do not know how to access their power to affect their own well-being through intentional self-care. Either/or results in a standoff that expends energy that could be used for positive purposes. A systemic approach is a more effective way to offset the problematic framing (Grise-Owens, n.d.-a).

Why is it important to make these distinctions, while emphasizing their complementarity, using a systems understanding? Pitting organizational accountability against individual empowerment and vice versa is largely counterproductive. These concepts need to be differentiated to expand understanding and be more effective in implementation. Intermingling these concepts will typically result in confusion and projection. When treated as distinctive—yet complementary—the systemic impact can be leveraged. Organizational leadership can identify arenas for attention, instead of projecting all responsibility onto employees.

At the same time, the individual practitioner can learn how to develop effective self-care strategies—thus, ameliorating the disempowering stance of waiting for the organization to change. That is, although employment entities, undeniably, need to do much more to improve organizational wellness, the individual practitioner also has power to affect their own well-being. This ability is even more crucial in systems with unhealthy cultures. Furthermore, the individual practitioner—as understood through the systems lens—can affect the larger organizational culture through dedication to micro self-care.

Self-Care as Competent Professional Practice

The fifth element of NASW’s policy statement on professional self-care focuses on the individual professional’s responsibility to attend to their own self-care—as integral to their practice role. Explicitly, the statement urges that practitioners should commit to specific self-care plans.

We, the editors, have been studying and promoting self-care as professional practice—along with working on organizational wellness—for over a decade. Much of our work is dedicated to studying best practices related to self-care and identifying ways and creating resources to help practitioners develop effective self-care (for example, Grise-Owens, Mill, & Eaves, 2016; Miller, Lianekhammy, & Grise-Owens, 2018). We have learned that one of the most harmful myths about self-care is that people know how to do it!

Thus, the statement’s sixth and seventh items are particularly key, emphasizing the need for supports for practitioners in practicing self-care, including continuing education offerings, support groups, professional retreats, and so forth. Social services organizations and employers have responsibility for offering these supports. However, professional organizations (such as NASW, the International Federation of Social Workers, and so forth) have a responsibility to advocate for self-care and provide needed resources (for example, trainings, materials, and so forth).

Another significant barrier to social workers’ self-care is the limited conceptualization of self-care. Typically, self-care is conceptualized as activities (usually physical) that occur after work—to recover from work. This framing of self-care as “recovering from work” leaves out the crucial aspect of how to practice self-care as part of work—that is, during work hours. Regrettably, this limited understanding of self-care has been magnified in the “buzzword” phenomenon. This narrow understanding of self-care results in limited applications and, predictably, often ineffective implementation.

Two explicit complementary changes can address this problematic phenomenon. First, a holistic conceptualization of self-care is needed (for example, Grise-Owens et al., 2016; Pyles, 2018). A holistic understanding expands the domains of self-care to include all areas of living that affect one’s well-being—including physical, social, psychological, and so forth. This expansive, holistic conceptualization may include practical self-care, spiritual self-care, financial self-care, and any other aspect of self-care that is significant to the individual.

Second, self-care needs to be understood as an integral aspect of professional practice—not just something to be done in our personal time. Professional self-care is a crucial dimension of holistic self-care (for example, Lee & Miller, 2013). Professional self-care can be defined as practicing self-care as part of one’s work. This type of self-care includes a myriad of elements—such as use of supervision, pursuing professional development, setting boundaries, practicing mindfulness, infusing healthy lifestyle patterns at work, and so forth. Professional and personal self-care are reciprocal and complementary. Attention to the conceptualization and practical applications of professional self-care is critical for effective implementation of holistic self-care. To reiterate, the NASW (2009) policy statement on self-care asserts that self-care is “an essential underpinning to best practice” (p. 268). That is, self-care is essential for competent professional practice (for example, Jackson, 2014).

Therefore, just like other professional competencies—such as interviewing, resource brokering, policy analysis, research, and so forth—we advocate that self-care be considered a practice competency. The Council on Social Work Education (CSWE) (2015)—the organization that sets the accreditation standards for social work programs—promulgates a holistic view of competency. That is, competence is “informed by knowledge, values, skills, and cognitive and affective processes that include the social worker’s critical thinking, affective reactions, and exercise of judgment” (CSWE, 2015, p. 2). 

Thus, to develop competence in self-care, social workers must acquire pertinent knowledge and develop skill in how to do self-care. Equally important, social workers must understand the value of self-care and its pertinence to professional practice. Finally, social workers need to be encouraged to consider self-care critically and thoughtfully. This consideration needs to take into account affective processes. For example, helping professionals frequently feel guilty for taking time to attend to their own needs. Overcoming these affective barriers is part of embracing the value of self-care for effective and ethical professional practice.

These aspects of competence are “developmental and dynamic, changing over time in relation to continuous learning” (CSWE, 2015, p. 2). Like all other competencies, self-care requires intentional development and ongoing attention. As an important professional competency, self-care is not a check-box item or superficial extra.

Self-Care as Integral in Socialization to the Profession

As such, self-care competency development needs to begin in educational programs that prepare professional social workers. The eighth and ninth items of the NASW policy statement on professional self-care emphasize this pivotal role of social work education programs, including the field education component. Socialization to the profession occurs through social work curricula, which set the foundation for ongoing practice. Curricula convey to students what is important. Giving lip service to self-care, without any serious curricular attention, is woefully inadequate. Pragmatically, this curricular attention should be integrated throughout the curriculum, for developmental purposes, through specific content and assignments (for example, Grise-Owens, Miller, Escobar-Ratliff, & George, 2018).

However, like all areas of curricula, faculty and field supervisors need to acquire expertise in self-care and how to help students learn about it. Educators need to be trained in how to integrate self-care into social work curricula (for example, Miller, Donohue-Kioh, Larkin, Niu, & Womack, 2018). The assumption that anyone can teach self-care minimizes the complexity of this integral competency. Similar to the buzzword issue noted earlier, too often faculty and field supervisors superficially add self-care, without deepening their own understanding. Again, as with all competencies, educators do not have to be perfect in their self-care. However, they are responsible for “developmental and dynamic” engagement with self-care as a professional competency.

CSWE sets the overarching priorities for curricula and programmatic mission and goals. CSWE (2015) “supports academic excellence by establishing thresholds for professional competence” Educational Policy, p. 1). Given the importance of self-care and the impact of socialization, it behooves CSWE to proactively consider requiring attention to self-care in curricula. Students need curricular preparation; educators need resources for this preparation. The profession needs this crucial support for achieving the profession’s core purpose of promoting “human and community well-being” (CSWE). This core purpose requires sustaining the well-being of social work practitioners through serious attention to self-care competency.

Toward a Self-Care Movement

The final emphasis of the policy statement is pursuing research. This special issue contributes to that aim. Special issues of journals give focused attention to an often neglected or emerging topic that is gaining pertinence. However, this attention must not stop with a “special issue.” Rather, we hope this issue is an impetus for much more ongoing, serious attention to self-care. We hope to see articles on self-care routinely published in subsequent issues of this journal—and in the literature, more broadly.

Self-care (and, conversely, neglecting it) affects every practitioner in the field and every organization’s and agency’s services. Self-care affects every cause, every client, and every community. Self-care is a shared global concern. International settings may have varied contexts, unique approaches, and cultural differences; yet, self-care is a universal element.

As recognition of the need for attention to self-care has grown, a metaphor has emerged that compares self-care to the mask that the individual puts on when the airplane is crashing. This comparison typically emphasizes that one must take care of oneself, to be able to take care of others. Although initially useful, this image can (unintentionally) promote self-care as an add-on—a “mask” to be used in urgent situations. Thus, it can reinforce the notion of self-care as something the individual practitioner does when already “crashing”—that is, experiencing burnout.

In contrast, we propose that self-care is “breath” (Grise-Owens, n.d.-b). Instead of a mask—used in limited and usually urgent situations—self-care is the essential, routine breathing that keeps the practitioner alive and flourishing. For far too long, the profession has largely neglected the well-being of practitioners. Burnout has been (albeit, usually implicitly) accepted as status quo for social work and other helping professions.

Fortunately, self-care and organizational wellness are gaining much-needed attention. Definitively, self-care is not merely an optional add-on, a mask for emergencies, or a passing fad buzzword. Regardless of any other lofty and crucial aims, if the profession does not give serious attention to the “essential underpinning,” that is, breath of self-care, the survival and growth of the profession is endangered. To ensure the survival and growth of the profession requires more than a special issue on the topic. It requires a sustained self-care movement to radically change the culture of the profession to one of well-being.

We are grateful to NASW for providing leadership in promoting self-care as professional practice and, specifically, for providing the forum of this journal for that promotion. We extend appreciation to the authors in this special issue for broadening the dialogue, deepening the conceptualization, and expanding the knowledge base. Their contributions reflect serious attention to the necessity of self-care for effective social work practice. In doing so, they add significantly to the self-care movement.

We invite you, the reader, to join the movement. Much more is needed. Moving forward, the profession needs pragmatic models, useful frameworks, tested best practices, informed critiques, expansive research, and practice reflections on self-care. We invite colleagues to apply the concepts and practices proposed herein. Challenge the status quo of burnout in our profession, through your own radical attention to self-care. Provide leadership in your work contexts to implement self-care. And, contribute to the conversation through presenting and writing about your engagement in self-care. We welcome further dialogue, as all of us—together—sustain the well-being of our profession through a self-care movement.

J. “Jay” Miller, PhD, CSW, is dean, College of Social Work, University of Kentucky, Louisville, KY 40252; e-mail: justin.miller1@uky.edu. Erlene Grise-Owens, EdD, LCSW, is principal partner, The Wellness Group, ETC, Louisville, KY.

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References

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© 2019 National Association of Social Workers
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