Client Violence and It's Effects on Traumatic Stress among Social Workers

Overview: In 16 in-depth interviews, social workers described traumatic stress caused by client violence (CV). They extracted CV examples and addressed worker rights to safety in three areas: violence assessment, coping strategies, and post-CV protection. Their voice is an advocacy vehicle toward developing worker-protection protocols enforced by the social work profession.Proposal text:

Background: Newhill (1996) defined client violence (CV) as “verbal abuse, threats, attempted or actual physical attack, intentional property damage against service provider by clients and their family members” (Newhill, 1996). Scholars have addressed the impact of CV on social workers (Lamothe et al, 2018; Radey et al., 2021; Radey et al., 2022; Zelnick et al., 2013). However, 65% and 86% of social workers reported CV-causing problems such as burnout, job turnover, safety concerns, and traumatic stress symptoms (Enosh et al., 2012; Ham et al, 2021; Jayaratne et al., 2004; Kanno & Giddings, 2017; Ringstad, 2005). Social workers have not advocated for their safety even knowing about client aggression.

Purpose: This study aims to (1) use the direct dialogues from social workers to analyze CV experiences and worker protection strategies, (2) generate worker dialogues to plan workplace protection protocols, and (3) identify traumatic effects of CV to advocate workers’ needs for building their support systems.

Method: This study recruited social workers from diverse work settings to address worker safety and well-being due to CV. With a snowball recruitment step, 16 social workers consented to participate in a one-hour interview. In each interview, semi-structured questions focused on workers’ experiences and perspectives towards CV. Probing questions included the impact and consequences after experiencing CV incidents. NVivo-12 was used for data input and triangulation with two coding cycles: open coding to identify violent acts and pattern coding to group the codes into themes.

Results: The participants were 24 to 61 years old (mean=44.25; SD=12.44). They worked in child protection (n=8), women shelter (n=2), hospital (n=2), behavioral health (n=2), hospice (n=1), and private practice (n=1). They had worked in the current position for 9.03 years (SD=5.32). All had experienced CV in their place of employment. Three themes affected their CV experiences: violence assessment, coping strategies, and social workers’ reactions to the incident. Responding to the assessment question, most social workers experienced increased CV incidents, mainly connecting to the clients’ non-compliance to agency policies. When suggesting coping skills, the participants stated ethical values and clinical skills were essential when dealing with traumatized incidents. They valued competence to communicate with clients but expressed a strong need to receive support from their workplace and personal networks. Social workers who felt traumatized by CV also indicated being weak after the attack by clients and fearful for their safety, which led to the thought of career change.
Implications and

Conclusion: There is a need to develop agency protocols for preventing CV and establishing worker support systems. Social work educators can facilitate classroom discussions and community projects to advocate for worker rights for safety protection, improve anger management skills, and highlight workforce wellness. Through direct conversations, social workers can contribute to case vignettes to demonstrate how to prevent CV when working with clients with emotional disturbances. Social workers’ voices can help analyze unsafe and traumatized incidents for improving crisis intervention skills. Practitioners can also take preventive measures with workforce support systems to develop a 360-degree protection plan for all involved.