When discussing child care, the focus is primarily on the welfare of the child. Although the well-being of the child care workers has long been generally and implicitly addressed in training and supervision, only recently has there been an effort to identify the problems confronting child care workers and to reflect their consequences.
The concept of occupational or job stress has only really developed over the last twenty years. Occupational stress refers here to workers' 'physiological and psychological responses to situations perceived as potentially disruptive' and which may be either desirable or undesirable. Going on vacation or being promoted may cause a positive kind of stress, of heightened awareness and sense of challenge. However, the emphasis in this paper will be on negative stress, which arises from those situations perceived as undesirable, painful and threatening to the ability of the worker to cope effectively.
"The 'burn-out syndrome' is an extreme response to occupational pressure. It has been described as primarily an experience of exhaustion resulting from excessive demands on the worker's energy and resources accompanied by a dehumanisation of the caring process. The 'burn-out syndrome' appears to be widespread among human service workers whose work require intense interpersonal involvement."
Recent years have seen great strides in the professionalisation of the child care worker with a corresponding advance in the quality of care for the child. Accompanying this advance has been the need for training and support systems. A well-known problem is the retention of workers and the quality of long-term care. Part of this is due to poor selection procedures. But a significant cause is the exhaustion experienced by workers. As a result there is a high staff turnover, potential apathy, and frustration for continuing workers.
Much resistance is met when facing the issue of job stress in the child care worker, as the implications are far broader than most would like to admit. It can bring systems face to face with change, when they may be more comfortable if left unchallenged. The upholders of rigid systems should realise that the ultimate beneficiaries of change would be the children.
Sources of stress in child care
Agency attitudes and policies contribute to the stress experienced by child care workers. Many agencies have enduring traditions which come from more autocratic times. Although endless red tape is something which doesn't directly concern the child care worker, it is something of which one is always aware.
Morale among child care workers is directly related to their perceived ability to influence the decisions affecting their work. On the one hand the child care worker is frequently perceived as the least valued of employees (low salaries are evidence of this); and on the other hand is the increasing awareness of the central role of the child care worker in providing quality care for the child. "Thus while being told of his importance, and encouraged toward professional associations and training, he is deprived of the economic and psychological circumstances necessary to engage in an exciting and productive career."
People become child care workers through a variety of motivations. However, there is an inescapable stress-producing conflict between the worker's commitment to giving, and the reality that frequently he cannot give enough. Each person's emotional resources are limited and the support offered by family, friends and colleagues is often insufficient.
Idealism vs reality
One confronts the reality with a certain idealism which more than often does not coincide with reality. Society values those who are concerned and care, but when one is faced with messy, rude and aggressive children, caring and being concerned is not that easy. This realisation is a threat to the workers' self-esteem and their own perceptions of their helping ability.
Child care work cannot be evaluated entirely in terms of job satisfaction and rewards, because we are dealing with people. Experiences which enhance effectiveness in child care appear very random and inconsistent. Many child care workers still lack the professional knowledge which would enable them to assess their own everyday effectiveness. Supervision is frequently neither rendered by skilled personnel nor readily available, and much supervision is exclusively problem-focused. Thus the worker is left without a realistic evaluation of his work.
The child care worker has constantly to process a great amount of information with great speed. Subtle nuance might be of vital importance. There are masses of verbal and non-verbal information, environmental conditions, the programme and immediate demands of the day, the history and treatment plan of each child, etc. The task of the child care worker is the use of the everyday environment as a support for the child's individual growth while completing the tasks essential for organised group living.
No place to hide
Daily practice is most often open to the view of superior colleagues, children, and occasionally to parents and even the community at large. There are few places to hide errors and bad days. There is no office door to close at five in the afternoon. In addition the child care worker is expected to serve as a model for the children.
It is often a fault of child care to try to put one's own experience of childhood at the service of the child, and to share some sort of empathic tension. Mattingly stresses that "workers remain fully adult, not identifying with the child nor allowing the child to be an inappropriate participant in their own psychological conflicts, while nevertheless remaining in touch with childhood perceptions and feelings. Negative emotions such as anger, guilt and potential loss of control are almost common. These are not congruent with the image of a helper of children and frighten many workers, particularly at the beginning of practice."
"For a live-in worker, limited opportunities for withdrawal, psychological repair and personal recovery are provided. Interpersonal interactions are also very intense. Living quarters may allow constant intrusions of children's noises. Personal phone calls and visits, as well as the security of personal possessions, may be severely limited." Off-time is constantly interrupted and it is impossible to lock oneself in one's room. These only serve to intensify all the stress producing influences.
The child care worker is expected to sustain some sort of professional identity with little support from the community. The common conception of the child care worker as babysitter, martyr or disciplinarian reflect the inaccurate understanding of the profession.
There are three basic components of burn-out which have been identified and measured, and these are emotional exhaustion, depersonalisation and lack of personal accomplishment. In addition, each person's stress response has a unique individual pattern of symptoms, behaviours and attitudes.
According to Mattingly, "burn-out frequently begins as a vague, subtle experience of discontent. The worker begins to have doubts about his caring work. He may feel inadequate to and overwhelmed by the tasks which confront him, and feel a growing, uncomfortable rigidity in his thinking and behaviour. He may be irritable, labile in moods, less empathetic, and behave, on occasion, in ways which are incongruent with his values or self-image as a helper of children. This experience is frequently confronted alone, and the worker often comes to the conclusion that he is unfit for the work he has chosen. A severe fracture of professional identity is a common result."
A decrease in the distinction between the time and place for personal life as well as a diminished distinction between the psychological needs of the worker and child may signal 'burn-out'. This is a hazard especially for the young worker. He may, more and more, rely on his 'work' to meet his personal needs. He lacks the energy and motivation to develop and sustain a rewarding personal life. It is often also quite impossible to develop a personal life because of the structure of the system, so he reconciles himself to his work as his only support.
Don't rock our boat
Another sign of 'burn-out' might be a certain rigidity and stubborn resistance to change. Personal resources are diminished and workers find themselves without flexibility. Sticking to old habits is far less stressful and any departure from the usual work pattern or any proposed innovations are experienced as personally intolerable.
A major source of support for the child care worker is trust in ones colleagues and reliance on their skills, goodwill and ability to help in the evaluation of ones work. The loss of trust in other members of the working team and the assumption of a self-sufficient attitude, often the result of overestimation isolates the worker from his colleagues and requires more energy, thus hastening 'burn-out'.
Excessive stress is also likely to manifest itself in physical symptoms. Health problems begin or intensify during the burning-out process. "An increase in accidents and injuries has also been speculated, as well as an increase in the use of escape routes such as food, tobacco, alcohol, and other mood-altering or tranquilizing drugs."
Stress resistance and recovery
An increase in workers' capacity for stress resistance and recovery can preserve their freedom to sustain a caring commitment and/or to follow the directions of their personal development. It is easy to imagine the ideal state and wish it upon oneself, but effective stress management requires careful practical and disciplined planning. Factors which should be considered include the following:
A lot more can be said about the stress which each child care worker experiences. It is an area of concern which still needs a lot of investigation and proposed solutions. Unfortunately it is a slow process of which we must be a part. It is important for every child care worker to have the opportunity to propose alternative organisation and to face change. Stress can never be totally eradicated, but a degree of management and the alleviation of its ill-effects is possible.
This article is reprinted from The Child Care Worker, Vol.2 No.1 April 1984, pages 5-8