Self and Collaborative Care for New Care Workers and Their Mentors

What if we created a different kind of workplace for and with new and/or young folks coming into the social work field?

Workplaces shouldn’t behave like frat houses repeating hazing rituals across generations. In frat houses, young people persuade themselves that the newbees must undergo the same embarrassments and tortures just because they had to endure them first. Similarly, social workers don’t have to burn out and be replaced by younger, fresher models just because that’s how it’s always been done.

This resource discusses the ethics and practical strategies for preventing C-PTSD and burnout. I made this resource because I get a lot of requests for advice on burnout prevention, and I think much of the help provided out there is more philosophical, academic or scientific than practical. Instead, this is like the “Cole’s Notes” of a book on PTSD in caring work. In this resource, I distill what I have learned about workplace PTSD and burnout after 15 years of working with homeless young people and women who have experienced violence.

I describe my past work as trauma-informed mentorship of young harm reduction leaders (traditionally called “peer workers”). Many entered the social work field after training in my program. It has been important to me to not simply pass on the torch to young people only to burn them out. This task has always been easier said than done. I hope this tool will help mentors follow an ethic of care for new workers. This resource is also written with the new workers themselves in mind — particularly students, new grads, and workers with lived experience.

Defining Burnout and PTSD

There are many terms describing the effects of doing care or crisis work. Some of these terms are “vicarious trauma,” “secondary trauma,” “secondary stress disorder,” “burnout,” and “compassion fatigue.” You can “burn out” from any kind of work, while vicarious trauma and compassion fatigue are specific to care or crisis work. They describe the difficult effects of “witnessing.” “Witnessing” can mean seeing something first-hand, observing the after-effects of trauma, or “holding space” for people’s emotions and stories.

Vikki Reynolds and others critique the concept of vicarious trauma because in early literature, it is talked about as if the clients “infect” workers with their despair. The term “compassion fatigue” is also critiqued because it suggests that we get tired from experiencing compassion; that it is not a bottomless resource. Compassion is a positive, expansive emotion that we simply find harder to access when we are overwhelmed. These terms also don’t capture that sometimes we can experience direct threats to our safety at work, so there is nothing “vicarious” about that. That is why I prefer to use the term work-related Post-traumatic Stress (Disorder) or PTSD. Indeed, many frontline workers could likely receive a diagnosis of Complex PTSD (C-PTSD) due to continuous stress.

A trauma is an incident that is scary: a threat to life, sanity, or bodily integrity. It could be physical, sexual or emotional violence, an accident, a natural disaster, war, living in jail, poverty, and so on. When someone says a person “has trauma” it means that the incident(s) has affected them psychologically, overwhelming their ability to cope. Stress is the way your body reacts to the demand or threat, causing physical effects like flooding your body with adrenalin, or making your heart beat really fast. Stress triggers the impulses to fight, flight, or freeze to defend yourself or others. You would be diagnosed with a “disorder” if the effects of the trauma get stuck in these modes, persisting over time and affecting day-to-day functioning.

We often get scared because we care, making caring both wonderful and painful. Often, our C-PTSD is compounded by grief over the deaths of our helpees as well as their past and current suffering. We also experience fear of more loss and pain. On top of that, we have feelings of frustration and powerlessness when faced with the astounding inadequacy and frequent violence of systems supposedly designed to help. It is NORMAL to have reactions of fear, frustration, sadness, high adrenalin, anger, grief, stress, overwhelm and so on. It is NOT normal to be living in these contexts of relentless danger and despair. If you’re reading this, know that it’s incredible that you’re still showing up.

It’s even harder for workers who have similar worries in their work and in their personal lives. For example, you’re not just scared that someone you help at work will die from overdose, you may also be worried for your friends. Maybe the person you help at work is also your friend. Over many years of mentoring young harm reduction leaders, I have observed that once community members consider them a resource, they come to the leaders for help even when they’re not on-shift. This need to be so constantly available is a major burden for folks on the “front lines” of multiple social crises.

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Audrey is an educator, counsellor, and curriculum developer running her own business in Toronto. She writes about social services, mostly.

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