BURNOUT NORTH OF 60 ii BURNOUT NORTH OF 60: AN INVESTIGATION OF TURNOVER AND BURNOUT AMONGST SOCIAL WORKERS IN NUNAVUT AND HOW TO BETTER SUPPORT THEM. By Cameron McKenzie, B.S.W. Thesis Submitted in partial fulfillment of the requirements For the degree of Master of Social Work School of Social Work McMaster University © Copyright by Cameron McKenzie, September 2012 iii MASTER OF SOCIAL WORK McMaster University (2012) Hamilton, Ontario TITLE: Burnout North of 60 AUTHOR: Cameron McKenzie, B.S.W. (Carleton University) SUPERVISOR: Dr. Donna Baines NUMBER OF PAGES: vi, 65 iv About the Researcher I developed a research interest in Northern communities when I worked as a research assistant in the Northwest Territories, during my undergraduate degree. I later had an opportunity to conduct a Bachelor’s thesis, in Nunavut, examining the impact of medical travel on Inuit, which deepened my interest in Inuit way of life. This prompted me to consider factors impacting social work efficacy north of 60. As a result, a literature review and this study were conducted to uncover trends associated with high stress and burnout amongst these social workers. While I have a passion for Northern Aboriginal research, it should be noted that I am a non-Aboriginal social worker, with no direct front line social work experience in the north. Despite these distinctions, I am a strong advocate and ally of Aboriginal peoples as well as northern social workers. v Abstract This qualitative study examines variables that can impact job stress, burnout, and turnover rates among social workers north of 60. The research herein seeks to fill in some gaps surrounding research on service worker employment conditions in the north that has not been specific to social workers serving Inuit clients. While the provisional literature review highlights possible conditions such as: social and geographical isolation, role stress, personality factors, and cultural and ethnic disparities as possible sources of burnout, these have never been evaluated in a manner specific to northern social workers. In-depth, semistructured interviews were conducted via telephone with nine former Nunavut social workers and directors in order to probe the issue of burnout and turnover. Application of Interpretive Social Sciences (ISS) and hermeneutical phenomenological approaches (HPA) to interview analysis revealed a trend in themes related to the administration of northern social work services, including: understaffing, lack of supervisory support, dual role stress, and overworked staff who already face the challenges of cultural incongruence for which they have been insufficiently trained to deal with. Final recommendations include increased attention and resources to the social work staff supporting vulnerable Inuit clients, including increased staffing and culturally sensitive training. vi Acknowledgements I am grateful to my supervisor Dr. Donna Baines from McMaster University’s School of Social Work. She has been a great support during each stage of my research, particularly the research study ethic approval process through McMaster University’s Ethics Review Board. Her dedication to this project was very helpful. I would like to also thank my second reader, Dr. Saara Green, also from McMaster University’s School of Social Work, for her support. I would like to extend my thanks to Dr. Lynn Mackenzie, Executive Director of Social Services, Department of Health and Social Services in Iqaluit, Nunavut, for the funding of this research. Lastly, I want to thank all the participants who took part in this study. Without them this study would not be possible. vii Table of Contents Introduction (Page 1) Context (Page 2) Literature review (Page 3) -Burnout amongst social workers (Page 4) -Role stress (Page 6) -Social Work in Northern Settings (Page 7) -Personality traits (Page 8) -Climate (Page 9) -Geography (Page 9) -Inuit Culture (Page 11) -Acculturation and Culture Shock (Page 12) -Social, Professional and Community Support (Page 13) Methodology (Page 15) Findings (Page 21) -Understaffing (Page 22) -Lack of Supervisory Supports (Page 24) -Geographic Isolation (Page 29) -Social Isolation (Page 30) -Feeling of Mistrust and Lack of Respect (Page 32) -Cultural Challenge and Gaps (Page 34) -Dual Role (Page 36) viii -Repercussion of the Child and Family Service Act (CFSA) (Page 36) -The Effects of These Factors: Stress and Burnout (Page 37) Discussion (Page 38) -Stress and Burnout (Page 44) Recommendations (Page 46) Conclusion (Page 49) References (Page 50) Appendix A- Map of Nunavut (Page 61) Appendix B- Visual Representation of a Hermeneutic Circle (Page 62) Appendix C- In depth Interview Process (Page 63) Appendix D- Interview Questions (Page 64) Footnotes (Page 65) MSW Thesis-C.McKenzie McMaster- School of Social Work 1 Burnout North of 60: An Investigation of Turnover and Burnout Amongst Social Workers in Nunavut and How to Better Support Them. Introduction There is little research on the subject of social worker turnover in the far north. The studies that are available, however, do show a high turnover rate among these community social service workers (CSSW).1 Typically they come from southern urban communities and may have little background knowledge or experience of life in the far north, making their transition more difficult and predisposing them to isolation and burnout. The rationale for this study is to shed light on whether social workers are leaving primarily because of burnout, why burnout occurs, and what can be done about it. The study looks at these issues as they are highlighted in relevant literature, followed by a discussion of practices within a northern setting, the research methods I utilize, analysis of findings from my interviews, and a discussion of their connections to existing research. Based on this rationale, the research explores the potential causes of burnout such as culture shock, isolation, the presence or absence of support systems, workload, and expectations of these social workers. I hypothesize that these causes heavily influence, both, burnout and high turnover rates among northern social workers. I further posit that the provision of greater and better employment supports for northern social workers may prevent burnout in the future and lead to a greater stability in social work staff within Nunavut, thus fostering a higher quality of care for their clients. MSW Thesis-C.McKenzie McMaster- School of Social Work 2 Context Before delving into the content of this study, it is important to understand Aboriginal groups in Canada and how Inuit2 are a distinct group. Inuit are one of three main Aboriginals groups in Canada comprising First Nations, Metis and Inuit, as recognized by the Canadian Government’s Constitution Act of 1982. Inuit, however, are not formally recognized in the Federal Indian Act (White, 2009). The distinctions used to divide status and non-status or Metis do not apply to Inuit, as no such distinctions exist in Nunavut (White, 2009). In a 1939 Supreme Court of Canada decision, the court held that the federal government had the power to make laws; however, these laws had to extend to Inuit (National Aboriginal Health Organization (NAHO), 2012). NAHO (2012) defines Inuit as the …circumpolar people, inhabiting regions in Russia, Alaska, Canada and Greenland, united by a common culture and language. There are of Canada, Alaska, Greenland and Russia. There are approximately, 55,000 Inuit living in Canada. Inuit live primarily in Northwest Territories, Nunavut, and northern parts of Quebec and coastal Labrador. They have traditionally lived for the most part north of the tree line in the area bordered by the Mackenzie Delta in the west, the Labrador coast in the east, the southern point of Hudson Bay in the south, and the High Arctic Islands in the north. (NAHO, 2012, p.1) MSW Thesis-C.McKenzie McMaster- School of Social Work 3 The Territory of Nunavut was formed in 1999. It was established as an autonomous region “with distinct status in the Canadian Federation” (White, 2009, p. 284). This allowed Inuit self- government to occur whereby “85% of Nunavummiut (the people of Nunavut) are Inuit” (White, 2009, p. 290). It is only since this time that Inuit have been officially recognized as a cultural entity in Canada and have, thus, garnered more attention from ethnographic researchers. Literature Review Current literature on stress in the workplace indicated that human service workers, including teachers, social workers, nurses, prison officers and police officers, are prone to higher levels of stress than those in most other forms of employment (Van Huegten, 2011; Johnson et al., 2005). Social workers and other psychosocial workers are especially subject to higher levels of stress resulting from exposure to violence and threats, high emotional demands, role conflict, the need to hide or suppress personal emotions, and the perception of having a low degree of influence in the workplace (Van Huegten, 2011; Rugulies et al., 2007; Lloyd, King, & Chenoweth, 2002). As a result, many social workers fall prey to stress-related disorders, described as “vicarious trauma” and “compassion fatigue,” leading to job resignation and burnout (Van Huegten, 2011, p. 25). In the workplace, this combination of excessive stress and a lack of supervisory support led to high staff turnover rates for social workers and a greater incidence of sick leave and absenteeism (Van Huegten, 2011). In Rugulies et al.’s (2007) study of 180 human service professionals, psychosocial work was found to be associated with a 71% increase in absence days due to sickness. In northern rural communities, social workers faced more challenges than their southern counterparts. The added challenges of working in the north included insufficient resources for MSW Thesis-C.McKenzie McMaster- School of Social Work 4 programming, such as addiction treatment and youth programs, geographic and social isolation, and cultural barriers (Phaneuf, Dudding, & Arreak, 2011). Research regarding northern rural social workers, however, remains in its infancy. Typically, human services workers who wish to work in northern rural communities come from southern urban communities, may have little working knowledge of life in the far north, and have a particular dearth of knowledge surrounding Inuit culture and customs (Phaneuf, Dudding, & Arreak, 2011, p. 32). As a result, these workers may be insufficiently prepared to face the challenges of breaching the cultural divide between themselves and their clients. They may also carry westernized or Eurocentric biases that make it more difficult for them to comprehend and assimilate traditional Inuit values and customs into their own social work practices (O’Neill, 2010). Such gaps in cultural and social knowledge jeopardize worker-client relationships as workers attempt to impose westernized helping modalities that intrinsically oppose Inuit ways of knowing and being (Grace, personal communication, August 15 2011). Furthermore, poor communication between worker and client, a lack of cultural awareness, and the workers’ cultural and geographical displacement can all perpetuate worker burnout (Phaneuf, Dudding, & Arreak, 2011; Zapf, 1993; Schmidt, 2002). ‘Burnout’ among social workers. In their study on burnout, Maslach, Jackson and Sanders (1982) defined burnout among health professional as emotional exhaustion, depersonalization, and a sense of decreased personal accomplishment (as cited in Kim & Stoner, 2008; Anderson, 2000). Together, these features were considered the precursors to burnout and provided a framework for understanding and evaluating social workers that were at risk. According to Maslach and Jackson (1986), burnout was a major factor influencing the turnover MSW Thesis-C.McKenzie McMaster- School of Social Work 5 of social workers within northern rural communities. In Nunavut, the glaring inadequacy of community social supports, especially the shortage of child and family service workers, was of great concern (Phaneuf, Dudding, & Arreak, 2011). These workers may be on call 24/7 for extended periods of time, which can lead to emotional exhaustion (Phaneuf, Dudding, & Arreak, 2011). In a recent review of the Child and Family Services Act (CFSA) by Terriplan Consultants (2010), in the Northwest Territories, social worker burnout was linked to unreasonable and excessive work hours, case overload, and social isolation. These features were also found to contribute to, and result in, job dissatisfaction and absenteeism, as well as an inability to attract and retain new, well-qualified social work staff (Phaneuf, Dudding, & Arreak, 2011). Social service deficiencies were outlined in a recent report of the Auditor-General of Canada to the Legislative Assembly of Nunavut in 2011. This document noted that as of the 2009-10 fiscal year an average of 17 of the 46 social service worker positions remained unfilled on a month-to-month basis by either a full time or temporary employee (Office of the Auditor General of Canada, 2011). These 51 CSSW positions are appointed by the Director of Child and Family Services, spread across the three regions in Nunavut; Baffin, Kivalliq and Kitikmeot. Amongst these workers there are 11 supervisor positions—5 of which serve one community and 6 serve two or more communities (Office of the Auditor-General of Canada, 2011). Supervisor duties included ascertaining staff compliance with the CFSA standards and administrative procedures (Office of the Auditor-General of Canada, 2011). In addition, the Review of the CFSA also revealed that role stress and burnout for social workers was exponentially greater within northern Canadian territories than in other territories or provinces (Phaneuf, Dudding, & Arreak, 2011). Most of these underlying issues resulted from limited infrastructure, poor MSW Thesis-C.McKenzie McMaster- School of Social Work 6 establishment and maintenance of social services systems, and the insufficient supervisory supports within the northern social work system (Phaneuf, Dudding, & Arreak, 2011). Role Stress. Role stress has been described a type of employee stress that emerged from boundary-spanning activities (Stamper & Johlke, 2003). Role stress encompasses role conflict, role ambiguity, and role overload, all of which can lead to or exacerbate burnout and long-term, negative, health consequences for social workers (Ben-Zur & Michael, 2008; Um & Harrison, 1998; Mor Barak, Nissly, & Levin, 2001). It often emerges from the increasing demands made of social workers in their current work settings, including paperwork, casework overloads due to staffing shortages, inadequate supervision, and challenging clientele (Kim & Stoner, 2008). Staffing continues to be a major issue for social workers in Nunavut. Kim and Stoner’s (2008) cross-sectional study was one of the few recent works that addressed the problems of burnout amongst social workers, particularly the intention to leave work due to burnout. Their study of 346 California state-registered social workers found that “role stress” positively correlated with burnout (Kim & Stoner, 2008, p. 5) and was a prominent antecedent to absenteeism (Huang, Chang, & Lin, 2003). Further, Kim and Stoner (2008) found that high job demands and insufficient job resources cumulatively influenced and impacted burnout as they contributed to the unattainability of task completion, goal-setting, and obtaining and maintaining job autonomy (Kim & Stoner, 2008). These problems cannot be understated as they implicate all social work departments, the quality of services provided to the clients, and the level of trust clients have in various social service systems (Kim & Stoner, 2008). Role stress, however, is only one possible factor contributing to conditions of burnout, as it has been estimated that one-third of all social workers undergo serious mental stress issues or MSW Thesis-C.McKenzie McMaster- School of Social Work 7 physical stressors, while more than half experience stress that is higher than they can safely tolerate or manage (Coffey, Dugdill, & Tatersall, 2004; Huxley et al., 2005). Many social workers, while physically present at work, may be unable to properly focus on the tasks at hand under these high-stress conditions (Van Huegten, 2011). Social work in northern settings. When working in isolated northern settings, amidst Inuit with their own cultural practices and standards, many unique and extreme role stress challenges emerged. Zapf (1993) analyzed the impact of role stress in northern communities and found that social workers tended to transfer work stress from their urban settings to their new, remote northern communities (Zapf, 1993). Role expectations, based on training in southern urban centres, were also found to come into conflict with the perspectives of northerners (Zapf, 1993). Specifically, insider versus outsider positions became blurred and problematized the workers’ expectations of previously established worker-client roles (Zapf, 1993). Many of these concerns resulted from the volatile nature of pressing client problems, the volume of clients, and the sparse employment supports (Gough, Shlonsky, & Duddling, 2009; Stephenson, Rondeau, Michaud, & Fiddler, 2000). These were deemed to be inherent to northern communities, which equated to increased worker demands and higher-than-normal stress levels (Phaneuf, Dudding, & Arreak, 2011). Client problems emerged from a history of deinstitutionalization and colonialism, delineating an impoverished, increasingly vulnerable clientele base that remains subject to perpetual funding shortfalls and continuous restructuring of social services (Stephenson et al., 2000; Gough, Shlonsky, & Dudding, 2009; Schmidt, 2000). According to O’Neill (2010), non- First Nations practitioners also feel “guilt by race” due to lingering effects of colonialism. This aspect of the culture shock, combined with high workloads, insufficient training and knowledge, MSW Thesis-C.McKenzie McMaster- School of Social Work 8 and exposure to emotional trauma found in clients, were all factors linked to heightened stress among northern practitioners (O’Neill, 2010). The workers described feelings of physical and emotional exhaustion as well as loss of compassion, which are recognized as antecedents to burnout (O’Neill, 2010). Furthermore, these experiences caused social workers to lose faith in themselves, leaving them in a position where they were unable to help their Northern clients (O’Neill, 2010). These levels of stress increased exponentially for those social workers employed in the areas of child protection and mental health due to compassion fatigue (Van Huegten, 2011; Conrad & Kellar-Guenther, 2006; Bennett, Plint, & Clifford, 2005; Anderson, 2000). Such, already challenging, work conditions can be further amplified by the social workers’ personality traits and coping mechanisms. Personality traits. Studies evaluating healthcare workers, including nurses and volunteer counselors, have attempted to address personality factors that contributed to role stress and burnout (Eastburg, Williamson, Gorsuch, & Ridley, 1994). Some personality characteristics identified as contributing to burnout included “low hardiness,” a disagreeable nature, introversion, low openness and conscientiousness, having an external locus of control,3 neuroticism,4 Type A behavior,5 and low self-esteem (Maslach et al., 2001; Zellars, Perrewe, & Hochwarter, 2000). Having a negative affect or negative personality traits were correlated with emotional exhaustion and the depersonalization facets, leading to an individual’s failed sense of personal accomplishments (Thoresen et al., 2003). Eastburg, Williamson, Gorsuch and Ridley (1994) identified extraversion as a burnout buffer. These individuals, however, required more interaction with co-workers and peer support in order to successfully avoid burnout, given northern isolation conditions as well as cultural and linguistic barriers (Eastburg et al., 1994). MSW Thesis-C.McKenzie McMaster- School of Social Work 9 Van Heugten (2011) suggested that personality traits played a role in burnout. Any combination of these personality traits or characteristics affected a social worker’s ability to cope with stress and their susceptibility to burnout (Van Heugten, 2011). Climate. Climate has been an important factor influencing social worker burnout and turnover amongst northern Canada’s helping professionals. Inclement weather serves as an isolating feature that in turn contributed to stressful rural social work practices (O’Neill, 2010). Stress related to the uncontrollable nature of weather conditions, often resulted in blocked roads, limited abilities to travel, and dangerous travelling conditions for social workers (O’Neill, 2010). The extreme cold can also be challenging, as many social workers are unaccustomed to frigid climates and have difficulty adapting to this type of environment (O’Neill, 2010). Nunavut’s climate varies based on the region. The average summer temperature in the capital Iqaluit, on southern Baffin Island, for example, can range around seven to eight degrees Celsius, whereas the average winter temperatures can be in the mid to high -20’s. During the summer solstice there is an average of 21 hours of sunshine for most areas, however, in Iqualit the shortest winter day consists of only four hours of sunlight (Nunavut Tourism, 2012). Grise Fiord is the coldest community with winter temperatures commonly falling to -50 Celcius, with a summer high of +5 Celsius. Geography. The geography and cultural milieu are additional factors that can influence human service workers’ burnout, stress, and ultimate turnover in northern Canada. It was noted by Macleod et al.’s (2008) in-depth qualitative study of 152 Registered Nurses (RNs) from all provinces and territories, that nurses, educators, and administrators who worked in rural and remote regions (population of approximately 10,000 people, located outside of the accessible MSW Thesis-C.McKenzie McMaster- School of Social Work 10 commuting distance from major urban centres) had difficulty adjusting to these geographic locations. O’Neill (2010) noted that the challenges of life, in the north, also included the vast geographic distances between communities and the separation between some communities because of the location of the regions and personal or cultural perceptions. These workers encountered personal and professional isolation as well as geographical remoteness (Schmidt, 2002). While most of these studies focused on nurses and other human service workers rather than social workers, they revealed insider-outsider distinctions as well as highlighted the isolation and burnout faced by many professionals within northern regions. Schmidt’s (2000) analytic literature review specifically explored challenges to social services and social work delivery, in the Canadian north, including dispersed and sparse populations, climate, transportation, and the nature of the northern economy (Schmidt, 2000). The northern provinces primarily relied on single serving industries, such as mining, pulp milling, or oil drilling, which can make the economy volatile as it remains subject to boom and burst cycles (Schmidt, 2000). These similar volatile conditions can also be found within the various social work positions. The outsider positioning of a social worker may be difficult to break free from due to various geographical, linguistic, and cultural barriers, which many social workers encounter when working in the north (Morin, Edouard,& Duhaime 2010). Social workers, in effect, were trapped in an environment where they had repetitive exposure not only to the traumatic experiences of their clients, but they were embedded in a small, geographically unstable, community (O’Neill, 2010). Nunavut can be considered geographically unstable because it is Canada’s largest territory with over 2 million square kilometers; with islands comprising of more than half of the territory (World Atlas, 2012). Many areas in Nunavut can MSW Thesis-C.McKenzie McMaster- School of Social Work 11 only be reached by sea or air given that the territory is mostly Canadian Shield, with various landscapes ranging drastically from flat to mountainous, broken into three regions: Qikiqtaaluk, Kivalliq and Kitikmeot (Nunavut Tourism, 2012) (See Appendix A). Inuit culture. Inuit culture has different characteristics and traditions than other Aboriginal cultures. Tester and Irniq (2008) traced Inuit history and its knowledge, Inuit Qaujimajatuqngit (IQ), in order to understand Inuit culture, traditions, beliefs, and ways of thinking. IQ incorporates a cosmological belief system, which focuses on managing biological resources in a seamless fashion, without separating humans from other forms of life (Tester & Irniq, 2008). It combines with Inuit’s guiding principles of Avatittinnik Kamatsiarniq: respect and care for the land, animals, and the environment; Ikajuqtigiinniq: working together for a common cause; and Aajiiqatigiinniq: decision-making through discussion and consensus (Nunavut Kavamanga, 2010). Inuit communities incorporate such core egalitarian values centring on equality, mutual responsibility, and the integrity of the community itself, in every aspect of their lives (Schmidt, 2000). Coates, Gray, and Hetherington (2006) and Gray, Coates, and Bird (2010) described the close-knit nature of Inuit communities. They explained how Inuit’s thrive in co-dependent, mutually supportive, psycho-social networks as these connections allowed them to cope with the challenges they faced (Coates, Gray, & Hetherington, 2006; see also Gray, Coates, & Bird, 2010). Central were conceptions of collective rights and self-governance, as this established equilibrium within these communities (Tester & Irniq, 2008). Inuit believed that the adoption of their history and knowledge into government policies and laws would allow for the preservation of Inuit cultural values, practices and traditions, and advance Canadian socioeconomics (Tester MSW Thesis-C.McKenzie McMaster- School of Social Work 12 & Irniq, 2008). Many aspects of Inuit culture, however, do not mesh well with the modern economic development models and neoliberal discourses, which focus on individualism, competition and privatization (Bodor, 2009; Braedly & Luxton, 2010). Acculturation and culture shock. The acculturation6 of Inuit has made working relations between social workers and this population precarious. Many of these fundamental problems are routed in historical events that led to cultural genocide and life-long traumas (Rae, 2011). Assimilation, mandatory schooling, residential schools, imposing non-Inuit value systems (i.e. prison systems, Western notions of legal rights, etc.) and colonialism have all led to the “loss of Inuit self-reliance, culture and way of life” (Government of Nunavut, Nunavut Tunngavik Inc., Embrace Life Council and the Royal Canadian Mounted Police, 2010). In addition, the neoliberal, economically motivated markets and push for industrial development stunt the development of Nunavut leading to continuous funding cutbacks for Aboriginals (Bodor, 2009). Social workers were often associated with these forceful western influences, therefore, Inuit look at them with caution, resulting in difficulty establishing trust between the worker and the client (Fearn & Spirit Moon Consulting 2006). This problem is further exacerbated by the continually high turnover rate among social workers in Nunavut, as just as social workers come to be known and trusted they leave and are replaced by strangers. In a time when Inuit are still dealing with the fallout of colonialization, while also being subject to many “modern realities” that threaten their culture, Tester and Irniq (2008), explained how it is important for social workers, and all northern helping professionals, to increase their knowledge of Inuit culture and way of life to allow for a practical social work application (Tester & Irniq, 2008). This was considered a way to not only help minimize culture shock for CSSW’s MSW Thesis-C.McKenzie McMaster- School of Social Work 13 when transitioning into new communities, but would allow them to start integrating IQ principles into the programs and services they wanted to offer prior to their arrival (Phaneuf, Dudding, & Arreak, 2011). Social, professional, and community supports. Along with the increased cultural awareness, the risk of burnout was also buffered by provision of social supports (Karasek & Theorell 1990; Houkes, Janssen, De Jonge, & Bakker, 2003). Karasek and Theorell (1990) and Houkes et al. (2003) felt increased social supports for social workers could help reduce work- related stress by increasing morale (Karasek & Theorell 1990; Houkes et al., 2003), which was found to reduce turnover rates among northern social workers (Um & Harrison, 1998). Integral to this concept was for individuals to establish their own support systems by developing partnerships with individuals and local groups, in northern communities, as this enabled workers to feel more integrated into local community life (Um & Harrison, 1998; Schmidt 2002), thus, giving these workers a feeling of greater job efficacy (O’Neill, 2010). O’Neil (2010) notes that increased social, professional and community connections made social worker more vulnerable to the pain and suffering of their clients, expressed as a form of secondary trauma (O’Neill, 2010). Schmidt (2000) suggested a new social development model toward addressing this particular problem—one that took into consideration and promoted social and economic development in the community (Schmidt, 2000). It was found that this approach empowered the whole population, while remaining sensitive to local traditions, interests, and values (Schmidt, 2000). Preparation and training of northern social workers has, until now, focused primarily on the formal education of these workers and highlighted the benefits of increased beforehand MSW Thesis-C.McKenzie McMaster- School of Social Work 14 cultural and region-specific knowledge (Zapf, 1993). Schmidt (2000) noted that to minimize stress, it would be useful to arm northern social workers with more extensive training in existing models of practice and conflict adaption or resolution. Through a context-driven focus, social workers would be able to position themselves as “non-experts” who were collaborative and identified as well as addressed the clients’ most pressing needs through a social justice, anti- oppressive and non-discriminatory lens (Schmidt, 2000). Additionally, Brown and Green (2009) have suggested increasing the number of placement opportunities in the north for those social workers who are contemplating working in these regions. These opportunities, as well as collaboration between incoming and outgoing social workers, were viewed as potentially effective preparatory approaches— the latter being especially useful in enabling social workers to capitalize on previous social workers’ experiences (Brown & Green, 2009; Misener et al., 2008). It also provided the necessary transitional supports needed for these social workers (Misener et al., 2008). Online resources were noted to be helpful as per Misener et al., (2008) who conducted a digital stress management support group study. They found that online resources were an outlet that allowed social workers opportunities to vent and discuss their issues or concerns with their colleagues, enhanced social workers’ coping strategies, and developed stronger online supports with peers who subsequently validated their concerns or provided the social, professional and community supports they required (Misener et al., 2008). While the results of this study were not statistically significant, it provided ways of addressing the limited supports for northern social workers (Misener et al., 2008). MSW Thesis-C.McKenzie McMaster- School of Social Work 15 Eastburg et al., (1994) determined that supervisory support played an important role in preventing burnout and was considered an important coping mechanism for human service workers. Specifically, they commented on how supervisors needed to maintain “consideration” and “structure” in order to determine “job satisfaction and burnout” (Duxbury, Armstrong, Drew & Henly 1984). Consideration referred to a style of supervision that entailed a mutually trusting relationship with staff, awareness of feelings, respect for opinions, and open communication (Duxbury et al., 1984). The role of structure determined the degree to which the supervisor takes on directing and managing the workplace, including criticisms, planning, and monitoring, to ensure the wellbeing of all employees (Duxbury et al., 1984). Their study revealed that supervisors who provided a high degree of structure and low levels of consideration contributed to more burnout and job dissatisfaction amongst their workers (Duxbury et al. 1984). It was also noted that supportive behaviors were enhanced when supervisors had positive feedback training and interacted with their employees, as it led to lower levels of emotional exhaustion (Eastburg et al., 1994). These types of open, supportive supervisory roles led to lower levels of burnout, better job satisfaction, and more effective and appropriate coping mechanisms amongst both supervisors and employees (Duxbury et al. 1984). Methodology This study’s aim was to evaluate the experiences of front-line social workers, in Nunavut, in order to understand the factors and circumstances that lead to high turnover and ultimately worker burnout. The methodological approach examined this phenomenon of burnout amongst social workers by combining an Interpretive Social Sciences (ISS) and hermeneutical phenomenological approaches (HPA). MSW Thesis-C.McKenzie McMaster- School of Social Work 16 The purpose of the ISS theoretical framework was to derive meaning from the experiences of individuals (in this case, front-line social workers in Nunavut) and then transform these meaning into an understanding of the circumstances and variables that impact specific phenomena or circumstances, like turnover and burnout (Neuman, 2011). ISS theory posits that reality is a social construct that is complex and constantly changing (Glesne, 2011). It acknowledges individuals’ subjective experience of their reality (Neuman, 2011). Inherent to this process is the ISS practical orientation of examining the everyday lives and tasks of ordinary people and conducting a “systematic analysis of socially meaningful action through the direct detailed observation of people” (Neuman, 1997, p. 68). In this study, the ordinary people were social workers and the tasks of interest included their jobs, roles, environment, and daily life interactions with Nunavut’s Inuit clients. ISS relates closely to hermeneutics, which is a theory of meaning that “literally means making the obscure plain” (Blaikie, 1993, p. 28 as cited in Neuman, 1997, p. 68). This has become the foundation of PHA, which involves an “interpretive process” (Creswell, 2007). Researchers build an understanding of their chosen phenomena by “mediating” (van Manen, 1990, p. 26) between different meanings in order to interpret their lived experiences (Creswell, 2007). Similar to ISS, HPA attempts to understand how people construct meaning around their lived realities (Neuman, 2011) and tries to interpret these experiences to determine its impact on both individuals and society (Laverty, 2008). HPA also recognizes and addresses researchers’ biases and assumptions that are embedded in the interpretive process, as well as interactions with interviewed participants (Laverty, 2008). In doing qualitative research, reflexivity is an essential tool for the researcher to MSW Thesis-C.McKenzie McMaster- School of Social Work 17 develop to better understand both, that which is being studied and the process of studying it (Pillow, 2003). The researcher must be aware of their own bias, assumptions and social locations, along with those of the participants’, as they emerge. in the interviews and analysis (Neuman 2011). For these reasons, I took field notes on each interview to gather probing questions and to document my internal thought process for data analysis. The phenomenological data analysis was used to translate the real-life experiences of the participants into a textual form reflective of its essential nature (Ajjawi & Higgs, 2007). The key strategy within this approach, was the use of the Hermeneutic Circle (Ajjawi & Higgs, 2007; Smith & Amrine, 1996) (See Appendix B), which begins and ends at the same place (with the self) and was a process of self-privileging because it recognized that all of the researcher’s findings existed in dialectical interaction with the self; that they are filtered through the researcher’s particular biases and understanding of the world (Amerine 1996 as cited in Smith & Amrine, 1996). The circle represented the process of understanding that evolved as the data (the parts) were acquired, thus, relating to the overall picture (the whole) and emerging as a developed interpretation over time (Ajjawi & Higgs, 2007). The understanding developed from this process was cyclical, since it ensured a conversation between the researcher and text, which was itself created by the researcher who used information obtained from the interview participants (Bontekoe, 1996, as cited in Ajjawi & Higgs, 2007). Together ISS and HPA provides for understanding an intensive analysis of specific phenomena, like high turnover rates and burnout, with the potential to generate themes with direct applicability to solving these problems (Glesne, 2011; Laverty, 2003). This study fulfilled the “postulate of adequacy” by providing an explanation that is MSW Thesis-C.McKenzie McMaster- School of Social Work 18 comprehensible as a common-sense interpretation of everyday life (Smart 1976, as cited in Neuman, 2011, p.105). Such an explanation included researcher subjectivities and observation in the final textual analysis, in order to yield results that were considered to be both valid and credible (Ajjawi & Higgs, 2007). Typically, the observations are made in a natural setting, but the timeframe and resources of this study confined data collection to in-depth phone interviews with participants, who were either working in the north, working some of the time in the north or worked in the north. The interview questions were derived from a literature review and discussions with the Executive Director of Social Services in Nunavut. Interview questions sought to disclose demographics as well as contributing factors to leaving one’s job and/or burnout (Appendix C). The questions explored social and environmental factors, such as isolation, climate and geography, participant subjectivities (i.e., workers’ own cultural and ethnic backgrounds, gender, specific job roles within their appointment, etc.) and social factors in order to try to pull apart how aspects of worker identity might interact with their perceptions of stress and burnout. This study was approved, in April 2012, by McMaster University’s Research Ethic Board (MREB). Participants were sought from the Executive Director of Social Services, Dr. Lynn MacKenzie, employed by the Department of Health and Social Services (DHSS). This occurred through a follow-up with a contact developed previously in Nunavut, who provided Dr. MacKenzie’s contact information. Dr. MacKenzie located 30-community social service workers in the DHSS’s records dating back two years, starting from April 2012. Those participants who agreed to be interviewed were provided a $50 honorarium in the form of a $50 VISA gift card, by the DHSS, once the interviews were completed. Of the 30 participants identified, only 23 MSW Thesis-C.McKenzie McMaster- School of Social Work 19 could be contacted because they had updated contact information. A recruitment script approved by the MREB was sent to the 23 workers (Appendix D). There was a success rate of 39% as ten responded, but only nine were interviewed. The one remaining participant was contacted numerous times, however, the interview never materialized. This qualitative study consisted of a data collection process that took the form of in- depth, semi-structured interviews. The process allowed for the compilation of a universal “composite description” (Creswell, 2007, p. 58) of “what” was experienced and “how” it was experienced (Moustakas, 1994). Semi-structured interviews have the advantage of establishing consistency across several interviews as each participant was asked a set list of questions, while simultaneously allowing for a more conversational interaction, permitting for a greater amount of data to be gathered (Guion et al., 2011). Three males and six females were interviewed. Two participants were Inuit and the others were non-Aboriginal. The job titles of eight of the participants were CSSW’s and one was the Director of Social Services in a remote community. Six of the participants were from southern provinces and two were from Nunavut and one was from the Yukon. Participants’ educational backgrounds and qualifications varied. Six of the participants had social work degrees; four had bachelor’s degrees and two had master’s degrees. The other three participants did not have social work degrees. Two participants had bachelor’s degrees in psychology, and one had a college diploma in human services. Interviews were conducted over the phone, digitally recorded, and later transcribed. Every attempt was made to clarify comments when needed to enhance understanding during the interview (Glesne, 2011). Participants were from all over Canada and interviews took place MSW Thesis-C.McKenzie McMaster- School of Social Work 20 between April to July 2012. Consent for the study was sent electronically to the participants, who then returned them back by mail, fax or electronically. In addition, verbal consent was sought and recorded prior to the commencement of each individual interview. Interviews typically lasted 30 to 60 minutes. Participants were assigned number from one to nine to maintain anonymity. All recoded conversations were stored in a locked cabinet and on the interviewer’s personal computer with a password protection. Participants were contacted for clarification of points that arose during the interviews, in order to ask more “operationalizing” (Kyale & Brinkmann, 2008, p. 135) or clarifying questions. All interview recordings and transcriptions will be destroyed within two years. “The Coding Manual for Qualitative Researchers” was used in order to aggregate, sort, and interpret the study’s data (Saldaña, 2009). Interviews were coded for common themes or patterns based on the social workers’ perceptions and responses. The key limitation of this study was researcher bias. As an emerging social work researcher familiar with issues faced by Inuit, in the North, my prior knowledge and information may have caused me to influence the participants’ responses with my personal views. The fact that only social workers were interviewed was also a potential source of bias because their clients or supervisors, who may have provided very different insights, were excluded. These methodologies were chosen so that researcher bias can be integrated into the study to make it richer and more applicable to real-world problems and experiences (Glesne, 2011). An additional weakness of this type of study lied with the skills of the interviewer and the training that the researcher received. Optimally, the interviewer needs to be trained in proper interviewing techniques; (Boyce & Neale, 2006) however, due to time limitations, qualitative interview techniques were researched and implemented (Guion et al., 2011; Opdenakker, 2006; Rubin & MSW Thesis-C.McKenzie McMaster- School of Social Work 21 Rubin, 2011). Finally, the retrospective nature of the interview data warrants caution. Some of the participants no longer worked in the North and had to recollect past circumstances, experiences, and variables that impacted their decisions to leave. A retrospective study requires the interviewer to stimulate recall and narration of personal, first-hand experiences (in this case, through the questions posed), which the interviewee narrates and attaches meaning to (Belk, 2006). Retrospective qualitative research presents specific potential biases related to how participants “document their past in a way that fits the present” (Silverman & Marvasti, 2008, p. 12), that is, no longer being employed as a social worker in Nunavut. This type of research can be particularly difficult to establish causality, as the interviewer was “inviting a retrospective rewriting of history” (Silverman & Marvasti, 2008, p. 12) that was more subject to biases related to self-concept. Nevertheless, interviewees will always colour their narrative with personal, social, cultural, political, and economic contexts (Godfry & Richardson, 2004; Mallinson et al., 2003). As Silverman and Marvasti (2008) have pointed out “there is no ‘objective’ reality to records,” yet oral histories remained incredibly valuable as they contributed in a prospective manner (p. 12). Oral narratives allowed for re-inquiry into an area and the re-shaping of future circumstances in order to generate a different (more desirable) outcome (Wilk, 2001; Wells, 2001; Hunter, 2001; Thompson, 2002). In this case, that desirable outcome was the retention of social workers through the alleviation of the perceived stressors that caused them to leave their northern social work positions. Findings The following results synthesized the answers to specific and impromptu questions posed MSW Thesis-C.McKenzie McMaster- School of Social Work 22 to nine frontline social workers that previously worked for the DHSS. The interview transcripts revealed seven broad themes of analysis: understaffing; lack of supervisory supports, isolation, feelings of mistrust and lack of respect, cultural challenges and gaps, dual roles, and repercussions of the CFSA.7 All of these factors were sited by the participants as having an impact on stress and burnout. Understaffing. The most commonly reported contributing factor to leaving a social work job in the north was understaffing. All nine respondents confirmed that understaffing was a major concern for them as they were always functioning in crisis mode. Participants (P) P1, P2, P5, P8 and P9 worked in Iqaluit, which has the largest population in Nunavut with a recent census population of less than 7,000 (Statistic Canada, 2012). These participants all experienced understaffing during their tenure in Iqaluit, where there were only six social work positions. P3 felt there should be at least 10 positions given the larger social problems, such as alcoholism, poverty, abuse and unemployment. Social workers in Nunavut reported constantly “running to keep up,” as they were constantly “jumping from one ‘fire’ to the next,” according to P2. These social workers were always dealing with emergency situations, which left them with no time to attend to their clients’ needs, such as preventative programming, workshops and skills development for their clientele. P5 stated, “It was like working in a MASH [Mobile Army Surgical Hospital] unit” and recommended more staff and additional preventative programs to minimize the constant crisis work mode. On top of there being few positions, participants who had worked in Iqaluit felt that they were constantly being overworked because a majority of the positions were not filled or there were vacancies due to illnesses or vacation (Office of the Auditor-General of Canada, 2011). This point was underscored by P8 who said: MSW Thesis-C.McKenzie McMaster- School of Social Work 23 …even though there were six [social workers in Iqaluit] on paper, at one point, we did have five, but the majority of the time we worked with three. Then if you’re working with three, we often worked with two, because people are away or sick. Temporary replacement workers were not helpful in the long term as they only contributed to the instability of work conditions and the inefficacy of staff. P4 exclaimed: …workers are in two, three, six weeks and then they’re gone, and new people come in. There’s constant turnover, and there’s no time for relationship building and continuity of service. Working in an office where there’s only four or five social workers, and, actually, only three social workers at any given time, considering people go on vacation—it’s kind of hard to service a town of seven thousand. P9 echoed concerns about understaffing being “the big issue” having stated that he had to do the job of at least two people during his five-year term, with a one-year leave of absence. Despite the fact that it was clearly evident to everyone who worked in that setting, understaffing remained a chronic, unresolved problem. P8 confirmed this point about understaffing given that she mentioned how she had never worked, in Iqaluit, when it was fully staffed. Understaffing concerns were also evident in smaller communities, where there was often only one social worker on staff at a given time. Most participants, however, felt that there should be at least two social workers present, which would make conditions optimal and comparable to the staffing, in nursing and police units, reducing stress and increasing their supports. P8 stressed the importance of peer support and the need to share the workload, particularly on-call demands. When “talking with other social workers up in the communities, they even felt much more MSW Thesis-C.McKenzie McMaster- School of Social Work 24 isolated than I did,” according to P8. The lack of staffing in these small communities was never addressed. P8 reiterated that there was a “real lack of sensitivity to the total isolation in some of the communities.” Most participants informed their supervisors about these situations, yet nothing was ever done to address them. P6 mirrored these concerns to say, You, as a social worker, in _______, you’re one person, but in every other collateral, professional in this town, they’re a team. I mean the RCMP are two. The nurses are two. The school is five. And here you’re one, and they all have very different views on how you should do your own job, right. And so, sometimes that was hard to navigate by, and that’s why I advocate that there really should be two people, two social workers in the community. Even experienced social workers, like P9, recognized the issues pertaining to burnout and high turnover rates, commenting “I think the communities that only have one worker are a big, big problem, because they don’t seem to keep workers, and I think part of it is because they are alone.” This situation thus served as a barrier to a satisfactory work environment for social workers working in northern provinces. These participants acknowledged understaffing barriers and how they not only led to high turnover rates, but the importance of supervisors and supervision for Nunavut social workers. Lack of supervisory supports. A serious concern amongst Nunavut social workers focused on the roles of supervisors and their supervisory capacity. This included supervisors’ decision-making abilities, their capacity to provide support, both emotionally and during work- related activities, and their overall skills in their supervisory roles. Eight out of the nine participants offered comments on the impact of supervisors and the management infrastructure MSW Thesis-C.McKenzie McMaster- School of Social Work 25 on their ability to cope when performing their jobs. When asked about what drove them to leave their positions as CSSW and what contributed to them developing stress and burnout, P1, P2, P3, P4, P5, P6, P7 and P8 answered that it was their supervisors or lack of supervision. Several participants felt that they did not receive the support they needed to carry out their tasks and to perform their work adequately. P6 said in this regard, You know I think about the two types of supervision I’ve had, Yukon compared to Nunavut. I mean it did feel tough in a sense to not see someone face to face (in Nunavut). Generally it is nice to have that face-to-face supervision. Personal contact was thus seen as an important aspect of a supervisor’s supervisory roles. Many supervisors were criticized for being unavailable or too busy to help their social workers. P6 reflected on this and said “one supervisor in Nunavut, she had her own case load. I think it created difficulties, because she couldn’t just focus on being just a supervisor and connect on that level. It was hard to get a hold of her.” On another level the supervisors were unable to follow through on promises and offered minimal real leadership, as many supervisors were involved in case management. Many participants felt this was not an appropriate use of a supervisor’s time or skills. This was noticed by P8, who replied, You know there were a number of issues, partly, certainly, it was the supervisor. Had we had a different supervisor I would have stayed. The incompetence at various levels… and when I had my evaluation by the manager, I was very clear on what I had felt that the supervisor… micromanaging… and not doing the things that she said she was going to do. Like we were going to do weekly MSW Thesis-C.McKenzie McMaster- School of Social Work 26 supervision, and these staff meetings, and huge, huge amounts of plans that never came to fruition. The importance of offering support and guidance for individually challenging cases was a pressing issue for participants and exemplified by P3 who expressed that “the supervisor is never really in the place to discuss, to talk, to discuss a case with you, to help you out, support you, You feel extremely lonely.” This supervisory absence social workers more frustrated and wanting more from their supervisors. A number of participants expressed that better communication, support, and supervisory guidance was needed not only locally, but also regionally. In discussing the stressful event that occurred in the community, P3 noted that there was “little support from the regional office… there is no real communication, I feel.” Likewise, P7 remarked that she “…felt the support from _______ was dismal” and went on to say, “Well, it was non-existent. And then, almost punitive, and I will not go back to ______ and report to that person again… So support is so important, I just need communication… sometimes I need direction. P7 also expressed how management roles required an even greater degree of commitment to the point of going out to remote communities to offer hands-on help and to mitigate the profound isolation and loneliness that affected social workers in those smaller northern communities. According to P7: So that’s the other thing I would say that is lacking in the north, is if you don’t have the right person in those key positions… and not to be just supportive over the phone, or to communicate when you send e-mails, or send documents, and, you know, you need a response back, and you need a signature…. But they really should be doing fly-ins, and going out to these isolated communities and spending MSW Thesis-C.McKenzie McMaster- School of Social Work 27 a few days with some of these new workers. And I think that is one of the problems as to why they’re not keeping their staff. It is not easy to be on your own. It’s not easy to feel like there’s no one you could call and get support, and just bounce things off. The same participant went on to talk about her specific experience, which influenced her opinions about supervisors, the need for more management or supervisor training, and her opinion of the current situation with social workers in Nunavut. I had an instance where a child had to get out of the community, but I couldn’t get a signature to get the kid out. I got no response, no response, and couldn’t get it. And winter was setting in and this kid was living in an abandoned house and they were using drugs, and I couldn’t sleep at night, and I didn’t have to go through that. It was a simple matter of a signature… So imagine if you’re a new young worker, or you’ve never been up north… I got bawled out for trying to communicate directly with their manager; my supervisor couldn’t, wasn’t getting a response either… I think management needs to be trained better. Some management needs to be trained better to be supportive, and to be available and communicative. P3 and P4 also mentioned concerns about the supervisory bureaucratic infrastructures in Nunavut. The first observation identified the cultural rift between Inuit family values and rules imposed by the bureaucracy in carrying out the laws of the CFSA of Nunavut. P3 indicated, In ________ I was told, because I have a friend who was working there, that at one point recently, they all resigned. That’s what I heard. Because you are always MSW Thesis-C.McKenzie McMaster- School of Social Work 28 at the mercy of the bureaucrats on top, who have no real contact with the community, and whose mandate is really to make the rules, to make sure the rules as respected, and in an Inuit context, dealing with Inuit family. How could it be? The multiple layers of bureaucracy were a problem for P4 who commented, You would have a regional director, and then underneath them there would be a regional manager, and then underneath them there would be a supervisor, where are you reporting to? Or you could be in God- knows-where, and you are reporting back to someone who’s down in the head office in _______. You know, it just seems so cumbersome. These bureaucratic obstacles had a significant impact on these social workers. Furthermore, conflicts between social workers in the field and their supervisors arose. P2 expressed this conflict to uncover how …the supervisor issue was kind of rough there for a while. It started out with one supervisor who turned out to be a little bit of a problem. We social workers ended up booting him out of the office. And then we didn’t really have a formal supervisor for, maybe six months, six months to almost a year. …So I had to say the support there wasn’t the greatest. As a result, many participants felt that inadequate supervision was a contributor to role stress and the risk of burnout since participants felt the workload affected their health, particularly their mental health. P2 also said, …the workload really affected my mental health at the end with some of the clients. The lack of clear supervision… The inadequate resources available to MSW Thesis-C.McKenzie McMaster- School of Social Work 29 me... We really did kind of operate on our own. We weren’t getting any direct support from our supervisor or director. When asked whether any types of support systems or programs were available to them while working in Nunavut, most of the participants disclosed that there was an employee assistance program available. These participants were aware of this employee assistance program, but many social workers did not access the services nor had little trust in it, since they found the idea cold and remote, and it did not offer support promptly when it was needed. P8 noted that, “I had just heard from people attempting to use it; you have to leave your number, like no one answers the phone, it’s a 1-800 number.” Other participants were not aware of the services available. Geographic isolation. Another related issue connected to the risk of burnout was isolation. In this context, isolation was based on climate and geography. Geographic isolation was due to the vast distances between areas, differences from having come from the south, limited means of transportation and the separation between communities, particularly where the only way to enter or exit was by airplane. The extreme cold of winter, bad weather conditions, the confining effects of storms and the climate overall, as well as the long hours of winter darkness, also contributed to this sense of geographic isolation. All participants had indicated that they worked mostly in these types of communities (i.e. accessible by plane only) with these types of circumstances (i.e. having come from the south or bad weather). The winter climate and darkness, according to P3, contributed to the stress of working in the far north as it affected not only workers, but their interactions or lack of interactions between workers. P3 spoke about “the harsh weather and the darkness. People are always influenced by the cycle of the seasons… The darkness, some people become tired when it’s dark.” P9 found the geographic isolation a large MSW Thesis-C.McKenzie McMaster- School of Social Work 30 problem …because, obviously, it’s a confined community. When I first went up… I was there for a year without leaving. That was difficult… And just not having access to a lot of things I’d want, like certain foods, services, and resources. And obviously, the northern climate was challenging. P4 indicated how “[y]ou could get kind of really down. I think adjusting to, not only the climate change, but also the light and the dark.” This was reiterated by P5 who expressed the isolating effect of the weather; “The weather there wears on you. The winters there are very, very long. You start to get cabin fever by about April…. It causes isolation, for sure. The darkness gets to you, you’re more tired.” P6 articulated this concern when he said, I would have been willing to work there longer. I could have done it for a year, but I knew beyond a year, I couldn’t …and I would probably have stayed there longer. It was, primarily, the isolation, of not having a team member to work with. This type of isolation was further compounded by social isolation. Social Isolation. Social isolation was a major issue for all social workers working in smaller northern communities. All participants emphasized the need to establish a network of contacts, friends and family, where possible, to provide additional psychological supports. P3 professed, The worst situation like that is if you are alone. Many social workers were alone. You are so isolated, and so unable very often to fulfill your own needs. Like needs to see good movies. Need to go for a meal with friends. MSW Thesis-C.McKenzie McMaster- School of Social Work 31 You need friends. You need a support system. And you need to be able to get out of this place. Several participants incorporated the impact of this type of isolation when they responded to questions pertaining to why they left their jobs or why they were stressed or experienced burnout. P3 expressed, …because the need to avoid the burnout, you need a break, or a sabbatical year, and vacation. It’s not always possible; it’s very expensive up here to travel. Just to leave ______ and Iqaluit and to go to Ottawa is twenty five hundred for a return. It’s more than going to Europe. P3 further stressed how taking a vacation was “not a luxury, it’s necessary.” As a way of countering the effects of isolation, P4 commented, Like you were so isolated, and there was so little to get involved in that there really wasn’t any place to go. I tried to keep it very balanced… as long as you made your opportunity to socialize and make some friends, and make some real connections. If you didn’t, it could become very lonely. P9 remarked, “It was good to have some family and friends for support, for sure. Like there’s no way I could have made it up there on my own.” It is relevant to note that P3, P4, P5, P6 and P9 made specific references to these isolation issues, while P1 and P2, who identified themselves as Inuuk, did not have these problems. P8 was not affected by isolation, claiming that she occupied relatively short temporary postings and felt her years of experience helped protect and prevent her from burnout. MSW Thesis-C.McKenzie McMaster- School of Social Work 32 Feelings of mistrust and lack of respect. Many social workers commented on how Inuit still had a lot of mistrust towards non-Aboriginals, which they attributed to the residual effects of colonialism. This was reflected in the comments and noted amongst all seven non-Aboriginal social workers. P5 summarized, You’re a white person, you’re a minority, and you’re going in, and you’re working with a population that doesn’t have a lot of trust for white people. …People look at you, who is this girl, and what is she able to do for us? And, is she OK? Can we trust her? Basically you’re going in and providing crisis intervention. And that’s difficult to do when you don’t have the trust of the community. That takes time to build. As per P4, “I felt people [Inuit] became very, very angry… here you have white people coming in, professionals, and they [Inuit] felt totally done to.” P1, who was Inuk, responded on how mistrust also occurred within the office where she worked as the social worker were primarily non-Aboriginal. She “felt that there was a bit of prejudice from workers from the south, non- Aboriginals” and experienced many cultural challenges dealing with their co-workers (P1). P1 said, “Mistrust amongst clients and colleagues made it hard for these northern social workers to make connections.” These social workers found it difficult to provide a continuous level of care or supportive programs because they felt alienated, excluded and rejected from these communities. Social workers expressed that they had a hard time trying to make a connection with their clients, due to the high turnover rate of northern social workers, the short-lived individual MSW Thesis-C.McKenzie McMaster- School of Social Work 33 placements and the lack of more permanent staff in these positions. P7 discussed her experience with an Inuk whose first question was “How long are you here for?” The social worker, P7, “was embarrassed to say I’m only here for two months. And so I felt that lessened my ability to be effective with them. It affected their ability to accept and work with you, because you were temporary.” The temporary nature of some of these placements and the short amount of time in any given community diminished the social workers capacity to be effective within the community and prevented them from obtaining the trust they needed for Inuit to facilitate communal change. Another common theme that was felt by seven of the participants was the feeling of lack of respect for their roles as social workers. P1, P2, P3, P4, P5, P6 and P9 specifically noted this as they felt that other professions did not have any respect for social workers. P5 indicated “their needs to be more respect for social workers.” These workers also felt that these negative perceptions were embedded within the community itself. Other social workers felt that this was a pervasive phenomenon because other human services workers, such as nurses or teachers, had salary incentives, travel grants, staffing support and sabbatical leave. This was emphasized by P6 who said, Look at the financial rewards that a nurse gets… various bonuses every month. For the social workers these don’t even exist. I feel that there’s a double standard; I feel that community social service workers are not necessarily as well appreciated as other supports in Nunavut. The participants expressed how demonstrating respect is needed in order to obtain resources and foster community growth. MSW Thesis-C.McKenzie McMaster- School of Social Work 34 Cultural challenges and gaps. An important theme involved the many ways in which the cultural challenges and gaps interplay between social workers (in the tasks they administered as representatives of the state) and their Inuit clients. These cultural clashes were more evident amongst the younger and newer social workers coming into Nunavut from the southern Canadian provinces. P5’s arrival in the north was a definite culture shock in terms of her level of knowledge about Inuit, whereby she revealed, “I knew nothing about Nunavut, I knew nothing about Inuit, absolutely nothing.” Southern social workers had little or no cultural knowledge or Inuit IQ. They did not understand the workings or challenges of applying the CFSA in Nunavut. The CFSA was established through a transplantation of the act from the Northwest Territories, which in turn was adapted from the province of Alberta. As a result, the CFSA’s origins, created tensions between social workers’ and their clients and increased the anger felt by Inuit when these workers apprehended their children. The CFSA did not reflect Inuit values and culture. P1, P3, P4, P5, P6 and P8 commented on these challenges of coming from the south and trying to adapt to Inuit culture and societal values. This gap made these social workers misunderstood by their Inuit clients, given that their roles or understanding of child protection and their application of the CFSA conflicted. P4 specified, In trying to do that we try to look at it through the eyes of what down south views are, and we’re really and truly not focused on the culture. We lose sight of the culture, of where they’re at, and I think that can be part of the major problem. This cultural gap had macro-level implications for P8. According to P8, MSW Thesis-C.McKenzie McMaster- School of Social Work 35 Certainly working with the supervisor, it had an impact on my decision to return to my home province. I think again, the southern mentality, you can’t bring your southern Canadian mentality into Nunavut, and expect things to be the same. She was pretty nasty in terms of alienating our foster parents. Divisions between northern and southern social workers’ views perpetuated colonial practices where Inuit children were then sent for treatments to southern programs in Alberta and Ontario. Similar to past residential schools, this practice failed to take into consideration Inuit values, customs, traditions and culture. As per P8, “[t]hey’re in an Aboriginal treatment program, they get homesick, they didn’t like the program, didn’t like the smudging… they’re not Aboriginal.” These programs were “not sensitive to Inuit culture” (P8). P5 echoed these remarks by indicating that the process of sending children and youths to southern facilities had a negative impact on these children and their families: socially, financially and culturally. These cultural challenges and gaps manifested tensions between the social worker and Inuit. The Inuuk social workers proved to be valuable for these social workers when they dealt with their clients. P1 observed, I never had any arguments. I treated them [Inuit clients] like a human being, accepting them the way they are. I used my traditional knowledge and values to deal with people, like, without judging, criticizing or telling them what to do. This social worker’s cultural knowledge and sensitivity allowed her to reflect on how “social workers, if they could learn more about IQ, if that could be implemented into the work environment, it would lead to a better understanding of Inuit values.” Inuuk social workers had a MSW Thesis-C.McKenzie McMaster- School of Social Work 36 better understanding of Inuit culture and traditions since they were able to relate easily with their clients. Regardless of their position, social workers, in the north, faced dual roles. Dual roles. One of the cultural challenges mentioned by P1, P2, P3, P6 and P9 dealt with these social workers’ finding themselves in a dual role when living and working in a small community setting. These social workers would meet clients in everyday circumstances, such as shopping or at social gatherings. Dual roles, as both a professional social worker and community member, were felt to be in conflict due to situations that arose, particularly ones that involved the apprehension of children or situations of abuse. P2 commented, “I dreaded the days I thought I might have contact with school friends. In this town, as soon as you become a social worker everyone knows about it, and you’re almost instantly hated by just about everybody in town.” This dual role made it hard for northern social workers to be in constant contact and meeting people in their routine daily social settings. P1 recognized how clients would have a habit of talking about their problems in inappropriate social setting, creating an uncomfortable atmosphere or situation for social workers. This was even more stressful for those social workers that were from the community. Repercussions of the Child and Family Services Act (CFSA). While the CFSA was not part of the initial interview questions, it became incorporated into the interviews after some of the earlier participants (P1, P2 and P3) mentioned how it was an issue and caused them stress. All of the participants, except for one, felt that the Act did not properly reflect Inuit needs and values. Many Inuit were suspicious of the Act becoming a constant source of conflict and cultural discord between the social workers, who must apply the Act and those affected by it: their Inuit clients. The conflicts and challenges that occurred because of the CFSA were brought MSW Thesis-C.McKenzie McMaster- School of Social Work 37 out by the observations of P3; There is a Child and Family Services Act, and this Act was just taken from the North West Territories (NWT), and plugged into Nunavut, and the rules were exactly the same, like apprehension and child welfare. It hasn’t changed to date. So, we were always torn between the child and family services and trying to work with family act x or z… So the burnout came mainly of having to constantly fight against the standard, the southern standard, and the place where you are living, Inuit community standard, and they always clash. In addition, P6 compared his experiences in the Yukon, with Nunavut, with respect to the CFSA. “It [the Act] probably needs to be updated. In the Yukon they have a brand new act and I would say it’s better. There are better tools available to plan with the family, such as a family group conference. I think that would be nice to have in Nunavut” (P6). Most felt the CFSA had a significant impact on their increased levels of stress and its contribution to burnout. The effects of these factors: stress and burnout. High stress was a recognized element of the social work profession, particularly for front-line CSSW. All the respondents, in these interviews, felt that there were varying degrees of stress in their job. Most felt burnt out or would feel prone to developing burnout if they had stayed long term in the northern community they were employed in. One respondent was very specific. P9 felt that being overworked, due to understaffing, was the main cause of what he claims was “classic burnout, just extremely low energy, irritable, always tired.” For eight out of nine participants, the workload was not manageable; thus, these added levels of stress led to exhaustion. P5 noticed, “I just needed to sleep and take it easy. I needed a stress leave and then I didn’t take it because we were the last MSW Thesis-C.McKenzie McMaster- School of Social Work 38 two in the office.” P2 mentioned, “if I started using alcohol to feel better and to go to sleep I’m going to become a full-blown alcoholic.” For these social workers, stress and burnout were noticeable and unavoidable. Discussion The purpose of this research was to investigate burnout risk factors their implication for turnover rate among CSSWs in Nunavut. Analysis of the interviews revealed several key themes leading to burnout and stress, including understaffing, lack of supervisory supports, isolation, feelings of mistrust and lack of respect between social workers and their clients, cultural challenges and gaps, dual roles and repercussions of the CFSA.8 Environmental factors were the major contributing influencing burnout. As such, the results of this study concur with the six environmental sources of burnout as identified by Maslach, Schaufeli and Leiter (2001): work overload, lack of autonomy due to rigid regulations and tight monitoring, insufficient rewards, unfairness and respect in the workplace, breakdown among community members and colleagues due to value clashes or conflicts with respect to work goals and priorities. All participants experienced these challenges to varying extents as they attempted to become integrated into the northern communities they worked in. Other authors, such as Corey and Corey (2011), listed similar factors leading to burnout in members of the helping professions. Their list included items such as “professionally taxing work without much opportunity for supervision,” “giving a great deal personally and not getting back much in the way of appreciation” and “working with a difficult population” (Corey & Corey, 2011, p. 318). High staff turnover and recruitment problems were seen to be emblematic of social workers, which has far-reaching consequences by creating a type of vicious circle of MSW Thesis-C.McKenzie McMaster- School of Social Work 39 loss of staff and increased workload for those who stay on the job (Van Heugten, 2011). These finding are consistent with the experience reported by social workers in Nunavut, who were constantly faced with a high turnover of staff and recruitment problems as well as resulting increased workloads. Turnover rates are thought to be a problem when exceeding 20% of staff per year (Nissly, Mor Barak, & Levin, 2005). This was consistent with the number of social worker positions filled by temporary workers: 25 out of 46, suggesting that turnover is a serious issue amongst Nunavut’s CSSWs (George, 2008). These issues and concerns expressed by participants had an impact on their abilities to cope, levels of stress (role stress) and increased their potential for burnout. In the area of understaffing, a direct corollary of this observation was the longstanding problem of recruiting and retaining social workers in northern territories (Bodor, 2009). The participants made these observations in response to the questions that asked them to reveal the factors they felt contributed to burnout and stress and that, consequently, influenced them to leave their jobs as social workers in Nunavut. Their responses were congruent with Minogue’s (2005) news report that indicated how “[s]ocial workers in Nunavut are handling too many cases without enough money or resources.” (p. 1) She added that, “Turnover is high for social workers, who often burn out on the job” (p. 1). The turnover rate and burnout, according to Maslach and Jackson (1986), remained a major factor amongst northern social workers, evident in the area of understaffing that was predominantly higher in remote communities. The reality of understaffing of Nunavut’s social workers was a recognized problem, as documented in a recent government paper; the Nunavut Social Services Review (NSSR) (Phaneuf, Dudding, & Arreak, 2011). In this document they noted that several factors contributed to understaffing, notably social and MSW Thesis-C.McKenzie McMaster- School of Social Work 40 geographic isolation, stress as well as salary and benefit issues (Phaneuf, Dudding, & Arreak, 2011). Understaffing was synonymous with work overload, which was given as a major cause of burnout in the index list of environmental sources for this problem (Maslach, Schaufeli & Leiter, 2001). This study’s findings are consistent with the Report of the Auditor General (2011) and Phaneuf, Dudding and Arreak (2011) highlighting the major concerns of understaffing and unrealistic workloads amongst Nunavut social workers. Yet, despite understaffing problems documented from over nearly twenty years ago to present, it remains an unaddressed issue. The recognition that proper supervision was essential to the success, health and wellbeing of social workers in the north has also been well documented. Lack of supervisory supports have been seen as a priority in the NSSR (2011) report and have been highlighted by social workers in this study. The NSSR (2011) report indicated that there is a need to optimize social services in Nunavut. Provision of knowledgeable and supportive supervision is, thus, a necessary strategy to help prevent burnout amongst northern and rural social workers in Canada, who have limited access to supervision or interactive supports from their peers (Bodor, 2009). This study’s findings corroborate those of both Schmidt (2000) and O’Neill (2004), whose work also noted the relationship between supervisory support and the prevention of burnout in northern social workers. Retention of child welfare workers, and the prevention of burnout, was also well recognized in settings other than the north in which appropriate supervision and support of workers was essential (Van Hook & Rothenberg, 2009). The importance of supervision and managerial support remains a key element in the task to prevent job-related stress and workplace burnout (Van Heugten, 2011). Following the criteria for sources of burnout by Corey and Corey (2011) and Maslach MSW Thesis-C.McKenzie McMaster- School of Social Work 41 and Leiter (1997), stressful work without adequate supervision was an important contributor to burnout because of the lack of collegial networking provided by supervisors. Many participants were clearly unhappy with the bureaucracy and how it operated given that the rules and regulations were a priority over the well being of clients. The finding echo those of Maslach and Leiter (1997), who found that employees felt they had no control over their work when they were forced to adhere to the insensitive application of the CFSA. In addition, many participants were left with a sense of powerlessness particularly in situations where managers were though to have made poor decisions or not adhere to their responsibilities. Various aspects of isolation have been found to contribute to stress, burnout and staff turnover (Phaneuf, Dudding, & Arreak, 2011; Schmidt, 2000, O’Neill, 2004; Misener, 2008). Isolation, both social and geographic, was cited by several participants as a key stressor contributing to burnout and to their decision to leave work. Social isolation was described by participants as encompassing: a lack of contact and support from colleagues, separation from family and friends, and being in an unfamiliar culture or place, particularly when the social worker was non-Aboriginal or from southern provinces. Once more, this loss of communal interaction with colleagues, due to both social and geographic isolation, as identified by Maslach and Leiter (1997), adds to the risk of developing burnout. These points were also featured in the Canadian literature relating to child welfare workers across Canada. Anderson and Gobeil (2003) indicated that “the feeling of belonging to a community and having a solid peer support network at work reduces burnout at management and front line levels” (p. 4). Participants in this study shared similar responses, complaining of isolation and being undervalued, which is congruent with previous studies (Alwon & Reitz, 2000; Soderfeldt, Soderfeldt & Warg, 1995). Clearly, MSW Thesis-C.McKenzie McMaster- School of Social Work 42 isolation remains an essential concern for CSSW’s in Canada, however, it is especially poignant in the north. Isolation, in turn, adds to facilitate burnout and ultimately job leaving, as the two are linked together in this manner (Huang, Chuang & Lin, 2003; Kim & Stoner, 2008; Drake & Yadama, 1996). Dual roles, living and working in a small community in Nunavut, even one as large as Iqaluit with around seven thousand people, means that a social worker cannot have the anonymity they would enjoy in a southern city environment when away from their job. As per Schmidt (2000), “It’s like living in a ‘fish bowl’ always under scrutiny by neighbours and your community, many of whom may also be clients” (p. 344). The participants saw this as negative, and a source of stress, particularly when doing an apprehension of a child as part of their child protection role, and then experiencing the backlash from the family involved or from other members of the community. Social workers found themselves caught in the middle, between their job responsibilities and the need to make connections and derive support from the community where they worked and lived, causing significant emotional and physical stress, as coincident with other research on role stress (Ben-Zur & Michael, 2008; Um & Harrison, 1998; and Mor Barak, Nissly, & Levin, 2001). The social location of the social workers, specifically if they were from Aboriginal community or from the south, influenced both their relationships with clients and their experiences of being social workers. On one hand, the Inuuk social workers felt less stigma working in their own community. However, according to my participants, when interactions were adversarial (such as in their child protection roles) they felt more vulnerable to community stigma. The non-Inuit workers felt tended to feel like outsiders, which tainted their relationship with the clients with mistrust, making it more difficult for them to feel connected to MSW Thesis-C.McKenzie McMaster- School of Social Work 43 the community. These circumstances led to an erosion of respect for the worker, generation of mistrust between social workers and their clients, as well as widening cultural challenges and gaps. Feelings of mistrust and lack of respect between social workers and their clients, cultural challenges and gaps and repercussions of the CFSA can be considered linked problems. These factors were particularly prominent for southern non- social workers that went to Inuit environments where Inuit looked upon them through the eyes of the colonized, having experienced years of maltreatment at the hands of European people or governments. These tensions included, but were not limited to: historical policies of assimilation, bureaucratic governance, and the imposition of non-Inuit values on Inuit communities (Rae, 2011). As expressed by the participants themselves, it was difficult to develop a trusting relationship with a social worker who was in the community for a relatively brief period of time, hence, this ‘revolving door’ approach to provision of social services was hardly conducive to long-term confidence amongst Inuit clients. Furthermore, Nunavuumiut observed that traditional Inuit culture and knowledge have not been properly respected or reflected by social service providers in Nunavut (Phaneuf, Dudding, & Arreak, 2011). Such perceptions served to create more barriers to acceptance for the social workers involved and added to their levels of stress and risk of burnout. When social workers looked at the problems of their Inuit clients with a southern mentality it led to unsuccessful interactions between the social worker and their clients given the various cultural gaps (Tester & Irniq, 2008; Bodor, 2009; Braedly & Luxton, 2010). The adversarial and conflicted roles these social workers took on when administering the facets of the MSW Thesis-C.McKenzie McMaster- School of Social Work 44 CFWA was reflected in both the literature and in my interviews with the participants. Participants recognized the shortcomings of the Act and the need for it to be amended (Rae, 2011). One could argue that these conflicts arose from administering the CFWA, which became another source of environmental stress that added to social worker’s risk of burnout (Maslach & Leiter, 1997). Phaneuf, Dudding and Arreak (2011) recognized these criticisms leveled at the CFSA in Nunavut. In fact, they noted that many Inuit viewed the Act more as a “weapon” than a “tool,” thus, shedding light on understanding the current adversarial nature of the interactions between communities, child and family services, and the need to make it more collaborative for all parties involved (p. 41). A specific deficiency was the lack of a post-apprehension review processes that left parents unable to appeal the decisions to apprehend their child(ren), within a reasonable time frame (Rae, 2011). This caused increased tensions between social workers and their clients since the CFSA as well as Inuit’s cultural practices were in constant conflict. The consequence was that it led to a toxic work environment and awkward living situations for the social worker. Stress and Burnout. Stress, and specifically role stress for the social worker, delineated in the literature review, was an added amplitude for northern settings, as laid out by Zapf (1993) and more recently by Phaneuf, Dudding and Arreak, (2011). For the participants in this study, stress permeated all aspects of the interviews. Job stress was amongst the salient factor contributing to burnout, in accordance to other studies (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001; Griffin, Hogan, Lambert, Tucker-Gail & Baker, 2010; Shin, Rosario, Morch, & Chestnut, 1984; and Rai, 2010). The heightened job stressors were interconnected with social workers intentions to leave their positions (Demerouti, et al., 2001; Hopkins, Cohen-Callow, MSW Thesis-C.McKenzie McMaster- School of Social Work 45 Kim & Hwang 2010; Mor Barak, Levin & Nissly & Lane, 2006). Stress, therefore, was a reality in the world of social work regardless of the setting, further amplified by the unique challenges of working in the isolated, remote northern areas of Nunavut and amongst a unique Inuit culture. The findings of this study revealed that the experience of these participants were not very different from child protection social workers in other settings. Amongst child protection workers, burnout was estimated to affect up to 50% of these workers within the United States (Conrad & Keller-Guenther, 2006). Burnout was caused by high levels of role stress, the experiences and struggles of being overworked and the issue of social workers’ encountering understaffing in northern provinces (Conrad & Keller-Guenther, 2006). Many of these social workers felt they needed strong supports from their supervisors and colleagues (Conrad & Keller-Guenther, 2006). What sets the northern workers apart from these previous studies was the added barriers of dealing with a cultural rift, administering a southern oriented CFSA, which was not tailored to Inuit culture, and the social and geographical isolation incumbent to working in Nunavut. Together, these tensions immerged as a result of the lack of trust of southern non- Aboriginal social workers, as a lingering effect of the colonial era where European involvement in Nunavut and Inuit culture threatened their way of life (Stephenson et al., 2000; Gough, Shlonsky, & Dudding, 2009; Schmidt, 2000; Rae, 2011; Government of Nunavut, Nunavut Tunngavik Inc., Embrace Life Council and the Royal Canadian Mounted Police, 2010). The constellation of themes generated herein, as supported by the literature, can be seen to be a recipe for burnout and high rates of turnover among social workers in Nunavut. The findings, thus, supported the rationale for this study, which was to outline the nature and causes for burnout and turnover among Nunavut’s front line social workers. This data revealed the MSW Thesis-C.McKenzie McMaster- School of Social Work 46 implications of isolation, poor supervision and cultural colonialism as large contributors to stress, turnover rates amongst northern social workers and burnout. This may be partially due to the development of coping skills over time— an attribute more likely to be associated with seasoned rather than young social workers (Boyas, Wind, & Kang, 2011), as evidenced by P7—a veteran social worker. Northern social workers experienced similar and often times heightened stress levels related to the nature of social workers in other jurisdictions (Van Heugten, 2011). All of this study’s participants encountered these struggles and obstacles as they tried to balance social, professional and community interactions. It was found that social, professional, and community supports played a vital role in terms of how the social worker adapted to the Northern work environment and the turnover rates within these positions. While personality traits have been found to have some impact on job performance and satisfaction in other studies, I did not specifically isolate this factor as a variable of study in my interviews, nor did my reflexive approach to data collection lead me to ask questions about the role of personality in the situations I was studying. My dialogue with the participants lead me to deduce that their challenges were based more on environmental factors than personality traits. Furthermore, as this is a preliminary study in an otherwise, untapped area of research, I felt that delving into personality traits was beyond the scope of initial inquiry. Recommendations These findings revealed that there are several areas of improvement that must be addressed in order to increase or even sustain the retention rate of social workers in Inuit communities. Social worker burnout and turnover issues implicate not only social workers’ experiences working in the North, but also the bridging of cultural gaps and inequalities between Inuit and MSW Thesis-C.McKenzie McMaster- School of Social Work 47 European colonial ancestry, along with oppression still experienced by Canada’s Inuit. A non- adversarial approach to interactions is essential to reduce tensions between social workers and their Inuit clients given the historical contexts. This may be achievable through preventative strategies and training of new or existing social service staff (Phaneuf, Dudding, & Arreak, 2011), such as how Inuit often make important decisions through consensus (Nunavut Kavamanga, 2010). Patience and time is needed in working with this population in order to build gradual consensus amongst the community to allow for the achievement of social change. It is also important to recognize that the summer months are significant to Inuit; therefore, they may be less inclined to keep appointments or even attend school during these periods (De Maio, personal communication, 25 June 2010). Attention to these differences can allow social workers to build insider relationships and to bridge the cultural gaps between themselves and their client. The most important aspect of the social worker-client relationship is developing partnerships with individuals and groups in the northern communities (Um & Harrison, 1998; Schmidt, 2002). What this does is avoid the power imbalances and issues faced by incoming social workers, shifting the role of the social worker away from that of the colonial agent to one as a collaborator for effective social change (Um & Harrison, 1998; Schmidt, 2002). It also removes the social worker from being in a position where they are imposing or forcing their own mainstream values onto Aboriginals (Um & Harrison, 1998; Schmidt, 2002). The types of social, professional and community supports available to social workers can ultimately impact all these client-worker relations. Additional recommendations that arose from this study include: 1. Train social workers so that they can provide culturally sensitive supports. This can include MSW Thesis-C.McKenzie McMaster- School of Social Work 48 training more local Inuit as social workers who can provide basic services within their respective communities. This is similar to the “barefoot doctors” disseminated by Cuba to staff rural health care facilities throughout Central and Southern America (Roemer, 1986). 2. Educate the community about social work mores, goals and the rationale for this profession. Encourage engagement by and within the community to reduce problems of child and family abuse, through workshops and other communal activities. This means increasing the involvement of elders who are highly respected and looked at for guidance and support. 3. Apply the IQ values in dealing with conflict in the community and with social workers. This allows for more culturally sensitive programming. 4. Amend the CFSA to reflect Inuit values and culture, which would address the interactions between social workers and their clients. 5. Use modern technologies; such as telephone or video conferencing techniques, to improve communication between social workers and their supervisors. This would eliminate the expensive site visits, which may be impractical. In addition, constant interaction with fellow social workers may help alleviate stress because they would ha