build a self-care program within the social worker's agency that covers all levels of practice.

• Analyze current risk and protective factors at each level specific to the case study.
• Propose a strategy for resilience at each level (e.g., policies, supportive programs, culture, advanced training, need for consultant).
  • Micro: Individuals and collegial peer relationships
  • Mezzo: Work teams
  • Macro: Organization and community
• Describe anticipated outcomes. How will this self-care program help the organization (e.g., productivity, deliverables, programmatic outcomes, turnover, employee engagement)?

Case study

Overview of the Organization

Berkshire Community Health (BCH) is a comprehensive healthcare facility serving western Massachusetts. BCH's central campus consists of emergency services; specialty medical units, including a leading oncology department; a behavioral health therapy unit; and a social work team. Social workers are integrated throughout the facility to support behavioral health and interdisciplinary care.

The social work team is supervised by Janell Morris, who is empathetic and supportive. Janell communicates effectively and encourages team-building through regular check-in meetings. The team is close and compassionate with one another. However, social workers often experience conflict with other collegial relationships beyond the team. As they are embedded within various units in the facility, they must work in interprofessional collaboration with other disciplines. Overall, social workers are devalued outside of the social work team.

Recently, BCH rolled out a public relations campaign in which they declared the organization to be "trauma-informed." However, no organization-wide policies or procedures have been implemented that reflect trauma-informed principles, nor were social workers consulted in the development of the campaign.

To support the health and wellness of staff, the organization has an employee assistance program that is available 24 hours a day, 7 days a week. The organization also offers premier health insurance for full-time employees. Full-time constitutes working at least 36 hours a week.

Social Worker 1: Tyrone

Tyrone is a 41-year-old male social worker who identifies as heterosexual, Black, and Latino. He is a divorced dad to a teenage daughter and shares custody with his ex-wife. Tyrone conducts individual therapy with clients at BCH to address mental health and substance use. In his therapeutic role, Tyrone sees individuals with complex trauma who have high therapeutic needs, compounded by high case-management needs. The expectation for this role is to see seven or eight clients per day, a standard that Tyrone has kept up with throughout his employment over the past 4 years.

Substance Use and Work

Tyrone, who has no recent history of substance use, has started drinking one to three glasses of wine at night and "nips" of alcohol during the workday. Tyrone explains that he "feels emotionally numb" and has difficulty concentrating and completing tasks at home and at work. He has begun to avoid people, places, and things that remind him of

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work with his clients, and he has also canceled sessions with clients who have higher levels of trauma to "stop my heart from pounding." Tyrone complains of decreased sleep due to nightmares, difficulty falling asleep, and experiencing anxiety, but reports that he can "handle it on my own" by "doing what I need to do." He has also expressed that he doesn't know why he continues to meet with clients because "I'm not going to help them in the end anyway."

Social Support and Self-Care

Tyrone describes limited social support. He declined invitations to social events for months, and, when he did attend, he'd just frustrate his friends by talking mostly about work. He also started expressing the belief that something bad is going to happen and that there is little hope for anything to change in the future. When friends attempted to confront Tyrone about their concerns, Tyrone became angry and irritable.

Tyrone stopped attending church 3 months ago because he was "too tired" to go. He had previously identified church as a primary support. Tyrone reports a positive relationship with his ex-wife. He also reports a good relationship with his parents, who live a couple hours away. For self-care, Tyrone attempts to journal 3 or 4 days a week and takes short walks with his dog in the morning and evening.

Anxiety

Tyrone describes a recent event in which his 16-year-old daughter came home several minutes late from a social event. He began thinking of a client he was working with whose child had been murdered. Tyrone was pacing, looking out the window, and texting his daughter repeatedly because he became extremely anxious about her whereabouts.