Supportive Supervision and Resilience Alliance to Address Secondary Trauma in Ohio: Preliminary Findings on Impact
In early 2018, as part of a needs assessment process, the Quality Improvement Center for Workforce Development (QIC-WD) conducted surveys with 588 Ohio child welfare workers across nine counties to assess organizational culture and climate (OCC), and secondary traumatic stress (STS). The results found that the organizational culture and climate across all participating counties was above average in rigidity and resistance, and below average in engagement. In addition, 53% of respondents experienced elevated levels of STS symptoms. STS can mimic the symptoms of Post-Traumatic Stress Disorder (Bride, 2007) including nightmares, sleep disruption, avoidance, and irritability. STS in child welfare has been linked to low rates of job satisfaction and staff retention.
The root cause analysis conducted by the QIC-WD (to determine why local agencies were rigid, staff were resistant and unengaged, and most staff were experiencing high levels of STS symptoms), zeroed in on issues related to supervision. Supervision was a challenge at every level from directors to managers, managers to frontline supervisors, and supervisors to frontline caseworkers.
The QIC-WD conducted focus groups with 90 supervisors across the nine participating counties and determined that supervisors felt they needed more skills in coaching staff and in providing supportive supervision. In addition, the supervisors felt that staff needed to develop stronger coping skills.
To address the findings, the Ohio Department of Job and Family Services (ODJFS) in collaboration with the QIC-WD created the workforce intervention Coach Ohio, a multi-level supportive supervision intervention that paired Resilience Alliance (RA) with strategies of supportive supervision including the Atlantic Coast Child Welfare Implementation Center (ACCWIC) Coaching Model.
As part of the exploration phase, the Coach Ohio team developed the following theory of change: When supervisors utilize a model of supportive supervision that emphasizes helping staff prevent and mitigate effects of secondary trauma and disengagement, then staff will acquire enhanced skills of reflection, emotional regulation, and coping, and they will experience less trauma and more support, which may lead to better job satisfaction and increased intentions to stay with the agency.
Utilizing a quasi-experimental design, the QIC-WD evaluation team compared responses from immediate post-intervention surveys by four Ohio counties and half of a large urban county that participated in Coach Ohio with responses from staff in three comparison counties and the second half of the workforce in the large urban county. Included in the surveys were measures of coping, resilience, optimism, perceived support, work-life balance, STS, job satisfaction, and intentions to stay or leave the organization. Multivariate analysis of variance (MANOVA) and regression analyses were conducted.
Controlling for workload, the MANOVA showed significant differences in the expected directions between those in the intervention and those in the comparison groups on coping, work-life balance, job satisfaction, intentions to stay, intentions to leave, and STS. Regression analyses on the three latter variables found participating in the intervention, perceiving work-life balance, reporting higher levels of resilience, organizational support, support from one’s supervisor, attachment, and less STS predicted job satisfaction. Furthermore, better emotional regulation, work-life balance, attachment, and personal stress, as well as less STS were predictors of intentions to stay with the organization. However, less personal stress, sense of organizational support, lower work-life balance, and more STS led to more intentions to leave the organization. Further analyses of thinking of quitting and looking for a job also showed the impact of the intervention and coping on those more active aspects of withdrawal. These preliminary results reveal efficacy in the Coach Ohio intervention on most expected outcomes.
Results from the rigorous evaluation that compares intervention counties with comparison counties will be available from the QIC-WD in late 2021.