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Nebraska Selects a Workforce Intervention: Addressing Secondary Traumatic Stress

The Nebraska Department of Health and Human Services Division of Children and Family Services (DCFS) workforce intervention will address secondary traumatic stress (STS) among frontline staff and supervisors. Nebraska is a state-run child welfare system with about 400 Child and Family Service Specialists (CFSS) organized into five service areas across the state. Currently, the annual CFSS turnover rate in Nebraska is about 30%, but DCFS is committed to retaining and supporting high quality CFSS.

Over the last year, DCFS has worked with the QIC-WD to review human resources (HR) data, feedback from the field (e.g., CFFS, supervisors, and administrators), and STS and organizational culture and climate survey data to understand what drives turnover among frontline child welfare workers. The needs assessment revealed that issues such as pay, opportunities to advance, relationships with the courts, supervision, and STS were amongst the biggest issues related to CFSS turnover. The team considered which issues could be addressed by Nebraska’s QIC-WD project, meeting both the goals of the state and the QIC-WD: addressing the current workforce, reducing turnover, and producing generalizable knowledge that will add value to the field of child welfare. Ultimately, an intervention to address STS was determined to be the best fit for Nebraska.

CFSS are exposed to a great deal of secondary trauma in their daily work with children and families. In December 2017, the QIC-WD surveyed about 40% of the CFSS workers statewide. More than half of CFSS surveyed reported elevated levels of STS. Building awareness of STS as an occupational hazard and equipping CFSS and supervisors with the tools to build resilience, restore hope, and manage stress is expected to better support CFSS in their job, which is expected, in turn, to decrease turnover. The QIC-WD is currently working with Nebraska to design, implement, and evaluate an STS intervention to improve worker retention.

In Nebraska, DCFS is looking to address job-related primary and secondary trauma in ongoing and immediate ways. The DCFS intervention is expected to increase self-awareness of STS, build staff skills and abilities to cope with and manage STS, and demonstrate the agency’s support for the well-being of frontline staff. Interventions to address STS have been implemented in a variety of child welfare agencies and show promise in early evaluations. A rigorous evaluation will be conducted to answer pertinent questions about how staff ability to cope with regular stressor can be managed and if improved resilience skills can decrease turnover.

Nebraska’s STS intervention will be piloted in early 2019 and implemented statewide in July 2019. DCFS and the QIC-WD will use implementation science to guide the rollout of the interventions and track lessons learned throughout this process. The key intervention components take approximately six months to complete. The QIC-WD will lead the evaluation and follow participants for two years. The data gathered through this study is expected to inform other child welfare agencies of how these strategies can decrease STS among frontline child welfare staff and improve worker retention.