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​Iowans Thrive Blog

​Featuring stories, research, and news on Iowa's movement to respond to ACEs

Protecting those who protect our kids

8/31/2020

 
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​Halfway into her son’s second baseball game of the day, Stephanie Reinhardt noticed he wasn’t playing third base. She went to the dugout and asked what was going on and he explained that his arm hurt. In the car on the way home, her son mentioned that he hadn’t played in the first game either.

“My own son didn’t play an entire game in the field and I didn’t realize it,” Stephanie says.
When Michelle Delong arrives home, she finds it difficult to focus on her boyfriend’s report of his day or doesn’t want to make decisions about what to do that evening after having made decisions all day. When eating out at a restaurant, she finds herself listening to other people’s conversations to look for safety or threats of safety. 
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These are examples the supervisors in Polk County Department of Human Services’ Child Welfare Division now recognize as the impact of trauma on their lives. Talking about these moments is a shift that’s happened as they have learned about secondary traumatic stress in the workplace and how to better support each other with difficult work that includes removing children from abusive situations and working with families who have experienced tremendous trauma.
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Chris Foreman, liaison with the National Center for Child Traumatic Stress, who has provided coaching for the supervisors, says: 

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When I first started talking with them, there was a lot of evident pain, tears, and not a lot of strategic thinking so much as being walking wounded. They were just hurting. And in six months, with very little effort on my part, they laugh, they have tried new strategies, and they have seen staff respond. They have done their own work to heal.
- Chris Foreman

Mid-Iowa Health Foundation and Polk County Decategorization (DECAT) funded the project with the recognition that in working with supervisors to address their own trauma, they could better support staff in making the best decision for children.

“Our goal was to understand who is wrapping around our kids, especially at their most vulnerable times,” says Suzanne Mineck, president of Mid-Iowa Health Foundation, “and clearly the child welfare system was a natural place for us to look deeper at how is it we better protect our kids by supporting those who are doing the protecting.”

“No one comes in here that doesn’t want to do the right thing for families,” says Stephanie. “This isn’t a glorified job. You sacrifice a lot of yourself to do this work, but to be able to do it in a healthy environment, this should have been done a long time ago.”


Starting with retention
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The trauma-informed work began after DHS had several failed child abuse cases that were covered in the media. Several staff left and new staff coming in lasted only a couple months before leaving.


A handful of supervisors formed a retention team to look deeper into the issue. At the same time, Teresa Burke, director of Polk County DECAT, who has an office within the department, saw the high caseloads staff were juggling and the stress they were under. 

“Teresa could see that we weren’t okay,” says Stephanie. “We were all in a state of trauma, and we weren’t healthy, our staff weren’t healthy, and we needed some help. She kept pushing, and pushing, and pushing until someone said yes.”

As a member of the Iowa ACEs 360 Coalition, Teresa was reading a lot about the impact of secondary traumatic stress, or the emotional duress that occurs when someone hears about the firsthand trauma experiences of another, and how that stress can significantly impact the well-being of people in helping professionals. One of the ways to address it, she found, was working with supervisors to create a trauma-informed work environment.  

Chris was already supporting a group in implementing trauma-informed services in Polk County Juvenile Detention, so Teresa approached MIHF about also covering her time for coaching with DHS supervisors.

“There’s a deep drive and passion for those who enter into this work,” says Suzanne, also a member of the Iowa ACEs Coalition, “and so we felt a need to hear them and to have them tell us what was missing and how they could better do their jobs and better support our kids.”

At first, the supervisors were hesitant to work with Chris: “We thought this is more of the same,” says Michelle. “We’ve tried this before. We’ve poured our hearts out and then nothing ever comes of it.”

But at a kickoff meeting with all the supervisors in October 2018, Suzanne opened with a message that the community cares and wants to support them.

“The flood gates opened,” says Teresa. “The supervisors were very emotional, crying and upset. It opened up right there.”
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Recognizing our trauma

Chris spent the day working with the 15 supervisors on understanding the effects of being oversaturated and how secondary traumatic stress can impact decisions. The supervisors shared their stories and Chris validated their thoughts and feelings. Labeling what they were experiencing and normalizing it changed the conversation.

When you do this work for so many years and you put your heart and soul into it—because you can’t do this work halfheartedly—you don’t know how it affects you. You just think, ‘This is how it is. This is how you are.’ Then when you start looking at it, you realize, ‘Oh, it is affecting me.’ So, I think that first step of getting people to look at and talk about it was important, because it is okay to talk about it.
- Stephanie Reinhardt
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Chris held monthly coaching calls with Teresa and 5-6 supervisors on the Retention Team to continue to work through their trauma and to think about steps to address it. She then returned in October 2019 to work with all of the supervisors. 

Chris’ focus has been on building protective factors in the workplace. One analogy she uses is how we prepare our house for winter through steps such as installing installation or making sure our furnace works. In the same way, how do we prepare ourselves for the tough work of our jobs?

Instead of applying a new strategy, Chris encouraged the supervisors to try on new lenses for doing their work, with an emphasis on building relationships and helping each other manage the stress.

“Trauma is inherently about isolation,” says Chris, so relationships become especially important.

“I think so many people felt like they had to suffer in order to be good enough at their jobs, to be worthy enough of their jobs,” she adds, “and we shifted the paradigm to your suffering is not good for them or anyone else.”
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Recognizing trauma leads to change

Chris especially helped the supervisors recognize the trauma they were experiencing as staff came to them in crisis about cases with families and leadership above set standards they had to meet for getting work done.

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The supervisors had to switch from thinking administratively about what’s not happening and why their staff are not performing the way they feel they should, and it became very personal. They internalized, ‘Oh my gosh this is what I’m doing. This is what I’m feeling.’ And once you get there, it’s a lot easier conversation to have on what you are doing and why it is impacting you this way and what are the skills you can build to work within that.
- Teresa Burke

Michelle, for example, now recognizes she has high standards for the work and becomes frustrated when she perceives staff or a peer didn’t do a good enough job on a task, so she steps back and does something else until she can re-approach the situation calmly and not assume ill intent.

The supervisors talk about how they used to “slime” each other by barging into each other’s offices to work through whatever they were experiencing at the time. Now they ask for permission to enter and don’t interrupt when someone has their door closed. Stephanie also has asked her team to not enter her office when she’s meeting with someone else or the door is closed, pointing out that she wants to be present with the person she’s meeting with.

“It’s really hard for them, because they’re moving at a pace where there is crisis and they feel their needs must be met,” says Stephanie. “But they also understand now that I want to respect you and I want to respect everyone else.”

In addition, the supervisors spend time saying hi to new employees and asking staff about their cases. They encourage self-care, with a zen den and by occasionally bringing in a massage therapist for staff.

The real shift, they say, has been labeling the trauma and giving themselves permission to focus on it. They now feel as though they have choices for how they interact with staff and can spend time working with the social workers they manage on how they interact with families in the community. They can better recognize when staff are in crisis and provide support.


A shift in culture

Michelle and Stephanie recalls tears from retention team members at the initial meetings with Chris. Now they laugh and joke. “That’s huge!” Stephanie says.

“The surprising thing is this has happened so fast,” Chris says. “Because there was a lot of hurt and the system has been through so much change. People are feeling different in the context where there is so much ongoing uncertainty. I never would have predicted that.”

Now that they’ve created a different culture, there’s no going back, they say. As new leadership and a new director of the department take on their roles, the retention team is working on how to teach them the culture that’s just been established.

“We have this opportunity to be able to teach them and show them a new way of doing things,” says Michelle. 

Caseloads are going to be high. People are hard to work with. People know all of that when they come here. What they don’t know they’re in for is a work environment that is not supportive, that is not trauma-informed or is full of complex trauma. There’s no going back to that.”
- Michelle Delong
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One outcome has been hearing from the trainers who work with new DHS staff that for the first time, staff are saying the department is a great place to work and they feel supported. At a recent retention team meeting, they couldn’t remember the last staff member who had resigned, whereas before, staff were resigning every week.
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The team is now looking to make a case for moving the work out to other child welfare departments to create a long-term impact. In the process, they are considering what a trauma-informed supervision program would look like and how to replicate it and sustain it.

As this rolls out, Michelle and Stephanie remain committed to what they need to do for their own self-care and to be there for their significant others and children.

“I’m a good momma,” Stephanie says. “My kids are wonderful, but I want be there, not just physically but mentally.” 
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  • ACEs in Iowa
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