IDEAS home Printed from https://ideas.repec.org/a/eee/cysrev/v122y2021ics0190740920323367.html
   My bibliography  Save this article

When doing the right thing feels wrong: Moral distress among child welfare caseworkers

Author

Listed:
  • He, Amy S.
  • Lizano, Erica L.
  • Stahlschmidt, Mary Jo

Abstract

Studied predominantly among nurses, moral distress refers to painful feelings or psychological difficulties related to awareness of the morally appropriate action to take but inability to take that action because of internal (e.g., fear) or external (e.g., lack of time or resources) constraints. However, little is known about experiences of moral distress among child welfare (CW) caseworkers. Drawing from existing moral distress and CW organizational literature, this study examined moral distress experiences among U.S. public CW caseworkers and the role of internal (professional training and psychological safety) and external (job stress and time pressure) constraints in this phenomenon. Data were drawn from a multisite CW workforce improvement project involving two state-administered and two county-administered CW agencies. These analyses utilized a subsample of CW caseworkers (N = 1,879). Logistic regression models were used to evaluate the relationships between constraint variables and two measures of moral distress, after adjusting for covariates. More than 60% of CW caseworkers reported experiencing one or both measures of moral distress. A lower sense of psychological safety, job stress, and time pressure contributed to an increased likelihood of experiencing moral distress. Results suggest that internal and external constraints play different roles in moral distress experiences, and more nuanced exploration of these relationships is warranted. Acknowledging the experiences of moral distress and understanding constraints that contribute to this phenomenon may be key to supporting CW caseworker well-being.

Suggested Citation

  • He, Amy S. & Lizano, Erica L. & Stahlschmidt, Mary Jo, 2021. "When doing the right thing feels wrong: Moral distress among child welfare caseworkers," Children and Youth Services Review, Elsevier, vol. 122(C).
    • Handle: RePEc:eee:cysrev:v:122:y:2021:i:c:s0190740920323367
    DOI: 10.1016/j.childyouth.2020.105914
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0190740920323367
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.childyouth.2020.105914?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. He, Amy S. & Lim, Caroline S. & Lecklitner, Greg & Olson, Adrienne & Traube, Dorian E., 2015. "Interagency collaboration and identifying mental health needs in child welfare: Findings from Los Angeles County," Children and Youth Services Review, Elsevier, vol. 53(C), pages 39-43.
    2. Boyas, Javier & Wind, Leslie H., 2010. "Employment-based social capital, job stress, and employee burnout: A public child welfare employee structural model," Children and Youth Services Review, Elsevier, vol. 32(3), pages 380-388, March.
    3. Kim, Hansung & Chenot, David & Ji, Juye, 2011. "Racial/ethnic disparity in child welfare systems: A longitudinal study utilizing the Disparity Index (DI)," Children and Youth Services Review, Elsevier, vol. 33(7), pages 1234-1244, July.
    4. Haight, Wendy & Sugrue, Erin P. & Calhoun, Molly, 2017. "Moral injury among Child Protection Professionals: Implications for the ethical treatment and retention of workers," Children and Youth Services Review, Elsevier, vol. 82(C), pages 27-41.
    5. Wells, Susan J. & Merritt, Lani M. & Briggs, Harold E., 2009. "Bias, racism and evidence-based practice: The case for more focused development of the child welfare evidence base," Children and Youth Services Review, Elsevier, vol. 31(11), pages 1160-1171, November.
    6. Stephen Wood & Johan Braeken & Karen Niven, 2013. "Discrimination and Well-Being in Organizations: Testing the Differential Power and Organizational Justice Theories of Workplace Aggression," Journal of Business Ethics, Springer, vol. 115(3), pages 617-634, July.
    7. Fong, Kelley, 2017. "Child welfare involvement and contexts of poverty: The role of parental adversities, social networks, and social services," Children and Youth Services Review, Elsevier, vol. 72(C), pages 5-13.
    8. Potter, Cathryn C. & Leake, Robin & Longworth-Reed, Laricia & Altschul, Inna & Rienks, Shauna, 2016. "Measuring organizational health in child welfare agencies," Children and Youth Services Review, Elsevier, vol. 61(C), pages 31-39.
    9. Douglas May & Matthew Luth & Catherine Schwoerer, 2014. "The Influence of Business Ethics Education on Moral Efficacy, Moral Meaningfulness, and Moral Courage: A Quasi-experimental Study," Journal of Business Ethics, Springer, vol. 124(1), pages 67-80, September.
    10. Lizano, Erica L. & Mor Barak, Michalle, 2015. "Job burnout and affective wellbeing: A longitudinal study of burnout and job satisfaction among public child welfare workers," Children and Youth Services Review, Elsevier, vol. 55(C), pages 18-28.
    11. Wojciak, Armeda Stevenson & McWey, Lenore M. & Helfrich, Christine M., 2013. "Sibling relationships and internalizing symptoms of youth in foster care," Children and Youth Services Review, Elsevier, vol. 35(7), pages 1071-1077.
    12. Kim, Hansung, 2011. "Job conditions, unmet expectations, and burnout in public child welfare workers: How different from other social workers?," Children and Youth Services Review, Elsevier, vol. 33(2), pages 358-367, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Greeno, Elizabeth J. & Gould-Kabler, Carrie & Bowman, Sara & Strubler, Kevin & Harburger, Deborah S., 2023. "Enhanced-youth transition planning: An innovative practice change with transition-age youth involved with child welfare in a rural setting," Children and Youth Services Review, Elsevier, vol. 149(C).
    2. Stevenson Wojciak, Armeda & Simpson, Jessica E. & Tomfohrde, Olivia & Wang, Guanyu, 2024. "Barriers and facilitators of sibling relationships of youth in foster care from an ecological perspective," Children and Youth Services Review, Elsevier, vol. 157(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Griffiths, Austin & Royse, David & Murphy, April & Jones, Olivia & Culver, Kalee & Turner, James & Smajlovic, Alma, 2023. "Exploratory factor analysis and reliability of the Child Welfare Employee Feedback Scale: Further revision (CWEFS-R)," Children and Youth Services Review, Elsevier, vol. 155(C).
    2. Boonzaaier, Emma & Truter, Elmien & Fouché, Ansie, 2021. "Occupational risk factors in child protection social work: A scoping review," Children and Youth Services Review, Elsevier, vol. 123(C).
    3. Thibodeau, Pari Shah & Park, In Young & Dunbar, Annie Zean & He, Amy, 2023. "What makes a good learning culture? The role of professional development among child welfare workers," Children and Youth Services Review, Elsevier, vol. 150(C).
    4. Lushin, Victor & Katz, Colleen C. & Julien-Chinn, Francie J. & Lalayants, Marina, 2023. "A burdened workforce: Exploring burnout, job satisfaction and turnover among child welfare caseworkers in the era of COVID-19," Children and Youth Services Review, Elsevier, vol. 148(C).
    5. Soffer-Elnekave, Ruth & Haight, Wendy & Nashandi, Ndilimeke J.C. & Cho, Minhae & Suleiman, Johara & Park, Sookyoung, 2023. "Re-orienting narratives of moral injury towards positive development: The experiences of emerging adults with child welfare histories," Children and Youth Services Review, Elsevier, vol. 149(C).
    6. Emily Keddell, 2022. "Mechanisms of Inequity: The Impact of Instrumental Biases in the Child Protection System," Societies, MDPI, vol. 12(3), pages 1-19, May.
    7. Smith, Richard J. & Clark, Sherrill J., 2011. "Does job resource loss reduce burnout and job exit for professionally trained social workers in child welfare?," Children and Youth Services Review, Elsevier, vol. 33(10), pages 1950-1959, October.
    8. Affrunti, Nicholas W. & Mehta, Tara & Rusch, Dana & Frazier, Stacy, 2018. "Job demands, resources, and stress among staff in after school programs: Neighborhood characteristics influence associations in the job demands-resources model," Children and Youth Services Review, Elsevier, vol. 88(C), pages 366-374.
    9. Garcia, Antonio R. & Circo, Elizabeth & DeNard, Christina & Hernandez, Natalie, 2015. "Barriers and facilitators to delivering effective mental health practice strategies for youth and families served by the child welfare system," Children and Youth Services Review, Elsevier, vol. 52(C), pages 110-122.
    10. Smith, Brenda D. & Prichard, Caroline & Boltz, Laura D., 2016. "Do child welfare job preview videos reflect evidence on retention and turnover?," Children and Youth Services Review, Elsevier, vol. 71(C), pages 210-216.
    11. Boyas, Javier F. & Wind, Leslie H. & Ruiz, Erika, 2015. "Exploring patterns of employee psychosocial outcomes among child welfare workers," Children and Youth Services Review, Elsevier, vol. 52(C), pages 174-183.
    12. Lizano, Erica L. & Mor Barak, Michalle, 2015. "Job burnout and affective wellbeing: A longitudinal study of burnout and job satisfaction among public child welfare workers," Children and Youth Services Review, Elsevier, vol. 55(C), pages 18-28.
    13. Schelbe, Lisa & Radey, Melissa & Panisch, Lisa S., 2017. "Satisfactions and stressors experienced by recently-hired frontline child welfare workers," Children and Youth Services Review, Elsevier, vol. 78(C), pages 56-63.
    14. Lee, Eunju & Esaki, Nina & Kim, Jeehoon & Greene, Rose & Kirkland, Kristen & Mitchell-Herzfeld, Susan, 2013. "Organizational climate and burnout among home visitors: Testing mediating effects of empowerment," Children and Youth Services Review, Elsevier, vol. 35(4), pages 594-602.
    15. Edwards, Frank & Wildeman, Christopher, 2018. "Characteristics of the front-line child welfare workforce," Children and Youth Services Review, Elsevier, vol. 89(C), pages 13-26.
    16. Emily Keddell & Gabrielle Davie, 2018. "Inequalities and Child Protection System Contact in Aotearoa New Zealand: Developing a Conceptual Framework and Research Agenda," Social Sciences, MDPI, vol. 7(6), pages 1-14, June.
    17. Hazen, Katherine P. & Carlson, Matthew W. & Hatton-Bowers, Holly & Fessinger, Melanie B. & Cole-Mossman, Jennie & Bahm, Jamie & Hauptman, Kelli & Brank, Eve M. & Gilkerson, Linda, 2020. "Evaluating the Facilitating Attuned Interactions (FAN) approach: Vicarious Trauma, professional Burnout, and reflective practice," Children and Youth Services Review, Elsevier, vol. 112(C).
    18. Engell, Thomas & Kirkøen, Benedicte & Aarons, Gregory A. & Hagen, Kristine Amlund, 2020. "Individual level predictors of implementation climate in child welfare services," Children and Youth Services Review, Elsevier, vol. 119(C).
    19. Stephanie Lange & Claire-Marie Altrock & Emily Gossmann & Jörg M. Fegert & Andreas Jud, 2022. "COVID-19—What Price Do Children Pay? An Analysis of Economic and Social Policy Factors," IJERPH, MDPI, vol. 19(13), pages 1-15, June.
    20. Woo Jin Lee & Inho Hwang, 2021. "Sustainable Information Security Behavior Management: An Empirical Approach for the Causes of Employees’ Voice Behavior," Sustainability, MDPI, vol. 13(11), pages 1-23, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:cysrev:v:122:y:2021:i:c:s0190740920323367. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/childyouth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.