A reflection on Social Work Students as the «Wounded Healer»

Emily Murphy

Mercy College, USA

CORRESPONDENCE:

Emily Murphy 

e-mail: emurphy4@mercy.edu

Abstract

Data from the literature supports that social work is a profession inclusive of students with a history of trauma. This reflective paper explores the impact of trauma on social work student’s performance in their field practicum. In addition this paper explores how social work educators manage, assist and respond to students with a history of trauma that affects their practice. Furthermore this paper delves into the challenges of the role of gatekeeper with students who are wounded healers and who have difficulties in managing what is required of them. Implications for social work education are explored specifically in regards to pedagogical approaches that support this work and what explicit and implicit curriculum responses are needed.

Keywords

Social Work student, trauma, wounded healer, post traumatic growth.

Introduction

Carl Jung’s concept of the wounded healer is applicable to social work students with a history of adverse childhood experiences. Wounded healers are individuals that want to heal their own history of trauma through helping others. Research indicates that social work is a profession that is inclusive of students with a history of trauma. As social work educators we may have to design pedagogy and course curriculum to best accommodate the learning, social and emotional needs of our students while also upholding the standards for our profession. Special consideration should be given to the social work students field education experience.

According to the Council on Social Work Education’s (CSWE) Educational Policies and Accreditation Standards, field education is the «signature pedagogy of social work education» (https://cswe.org). This designation underscores the role of the internship as the bridge for connecting the theories and concepts of generalist practice from the classroom to the practice skills in the field. As such, field education is systematically designed, supervised, coordinated, and evaluated based on criteria by which students demonstrate mastery of the program’s core competencies operationalized by the competence behaviors outlined by the School and CSWE.

As a social work educator and field education coordinator for Bachelors’ level Social Work students, I have experienced firsthand how difficult it can be to grapple with a student that’s academic and practicum experience is negatively impacted by their own history of trauma. I have also had the privilege of experiencing when a student with a trauma history feels empowered by their field practicum experience and contributes to their placements and clients in a meaningful way.

This reflective article will explore the Jungian concept of the wounded healer as social work student and how a history of trauma can impact a social work student’s performance in their field practicum. This article will also explore the social worker educator’s response to students with a history of trauma both as an educator and gatekeeper of the profession. Finally, this paper will consider pedagogical approaches that encourage success for all social work students regardless of their history of trauma.

Reflection: An Honest Conversation in the Classroom

It is a Friday afternoon, and I am talking to my social work students about their senior year field practicum experiences. It is mid-semester so they are just beginning to get settled into their roles. They have been observing their field instructors and some have started meeting with their own clients. This is the most exciting time for social work students; they can finally put what they have learned in the classroom into action. All of the theories learned and the social justice issues raised in class discussions are finally illuminated by real cases in real time. My goals for this class are to engage my students in an honest conversation about their field practicum experiences, the social work skills they are using, and offer a safe space for them to process their reactions to their cases.

Some students speak more than others and some, covering their faces, hold back their questions with a quiet reserve. One student hesitatingly raises her hand. She wants to talk about a personal reaction she had to a client. She appears nervous and I hear apprehension in her voice. The client she met with together with her supervisor disclosed that she had been sexually assaulted. My student said she felt sick to her stomach and could not make eye contact with her client; she expressed feeling waves of guilt and frustration about her reaction and what she described as her lack of readiness to deal with a significant interpersonal trauma. My other students began to share their own feelings of inadequacy in their placements and by doing so helped their classmate know she is not alone. We talked about being affected by the stories we are told by our clients, reminding each other that transference and counter transference are real and powerful phenomena and can happen to anyone.

The class ended and my student lingered. She asked a few questions about applying to graduate school and then her eyes started brimming with tears. She asked «Can I talk to you?», «Of course» I say. She begins to tell me her story. She tells me about the trauma she endured as a child and explains that is the reason why she chose social work as a profession. She also tells me how alone and depressed she feels being back on campus since the Covid-19 Pandemic. She expressed how worried she feels about herself and her future as a social worker. She asked if there was something wrong with her. She disclosed that she felt sick and could not make eye contact when her client disclosed her experience with sexual assault, which so closely mirrored her own trauma. She asked if she made a mistake choosing social work. I listened, I validated and empathized with her worries and fears. My role as her social work educator was to support and guide her to make her own decision about her future career. Through the use of the strengths perspective I wanted to help her see what went right, what she demonstrated as her skills and strengths and what this educational experience clarified for her. My student is the only one who can decide whether or not she made a mistake in choosing social work. As her social work educator, I want her to feel empowered and supported in assessing her future as a social worker based on her classroom and field education experiences.

Carl Jung’s Concept of the «Wounded Healer»

The idea of receiving help and wanting to give it back is nothing new. Carl Jung coined the term the «wounded healer» to describe individuals’ who strive to heal their own pain and trauma through helping others (Newcomb et al., 2015). In a qualitative research study completed at a South African University with third year social work students, the author found that «people choose careers for different reasons, but for social work, more often than not, there are deeply personal motivating reasons» (Dykes, 2016). There is significant data to support that people that have experienced trauma and/or hardship are more likely to choose a field like social work (Dykes, 2016). Black, Jeffrey and Hartley (1993) surveyed social work (n=195) and business (n=159) students and found that social work students reported a significantly higher frequency of family trauma than the business students. Rompf and Royse (1994) compared social work students with English majors and again found that social work students reported significantly higher incidences of marital discord, familial and emotional problems, and alcohol and drug addiction in their families of origin (Esaki & Larkin, 2013). Sellers and Hunter (2005) conducted a survey of 126 graduate social work students to determine the significance of problems in their family of origin on their career choices. Thirty-five percent of the students reported a family history of violence, 43% a history of psychopathology, and 44% a history of substance abuse (Esaki & Larkin, 2013). Overall 69% of the students reported a significant family history of turmoil that led to their career choice of social work. A 2012 study evaluating the mental health characteristics of sixty-eight undergraduate and graduate social work students at the Florida Atlantic University of Social Work found that thirty-four percent of their students expressed high levels of depression and were at heightened risk for clinical depression (Reardon, 2012). Thomas (2016) investigated social work student’s history of adverse childhood experiences and its connection to burnout in the field. Thomas concluded that social work students have higher rates of adverse childhood experiences than the general population which can ultimately impact burnout and professional sustainability (Thomas, 2016). Social Work educators should be aware of these findings as we design curriculum and strategies to ensure student success. This includes preparing them to protect themselves from burn-out early on in their social work careers.

The Social Work Student as a «Wounded Healer»

Applying the concept of wounded healer certainly provides more insight into the learning needs of social work students enduring these histories. It also gives us the tools to critically assess our social work pedagogy and curriculum and the impact it may or may not have on these students. Through the notion of the wounded healer, we can clearly identify our most vulnerable student’s strengths and challenges both in the classroom and in their field practicum placements. Research demonstrates that «childhood adversity can play a pivotal role in how students learn and develop professional competencies» (Newcomb et al., 2015). Wounded healer students can present with significant learning needs that as educators we need to be cognizant of. Jung saw the strengths in wounded healers. He believed that «wounded healers developed insight and resilience from their own experiences, enabling transformative interventions to occur with clients» (Gerlach, 2015). Social Workers with a history of trauma and/or mental health or substance abuse may be able to more readily empathize with their clients and help them make connections between trauma and the development of useful coping mechanisms. But while Jung saw the strengths of being a wounded healer, others had concerns. It was suggested that students with a history of trauma or mental health may display unresolved emotional issues in their direct practice making them more susceptible to counter transference, vicarious trauma and interfering with the clients healing process (Newcomb et al., 2015).

Trauma has a pejorative connotation attached to it and as a society we often focus on the negative implications of trauma. However, according to Post Traumatic Growth Theory (PTG), trauma while awful, can also transform an individual. In alignment with Carl Jung’s concept of the wounded healer, PTG focuses on the changes in people after a traumatic event rather than their responses during the event. PTG focuses on the transformative process individuals can go through post trauma through reflection. PTG also corresponds with a focus on an individual’s strengths and the potential of growth through crisis. PTG aligns well with our social work code of ethics and values of respecting client self-determination and empowering our clients through identifying their strengths and sources of competence. Individuals experiencing PTG may feel an «increased sense of self-reliance, a sense of strengths and confidence, and a perception of self as survivor or victim rather than “victim”» (Tedeschi et al., 2018).

In practice, we use the strengths perspective to help transform our client’s challenges and adversities to assist their ability to reframe the experience and to find the silver lining. This enables the individual to incorporate the experience into a new narrative. Thus, trauma doesn’t have to be the end of one’s story, it can truly be a new beginning to their story. This is what my student taught me. My journey with her opened my eyes and confirmed a reality that many social work students face. Many of us choose the profession of social work because we once needed help and desire to give back the help we received or perhaps, we wish to provide the help we so desperately needed and never got. We look to transform our own history of struggle through helping others.

Another student I taught stands out as someone who healed through healing others. My student has an extensive history of emotional and sexual abuse. She coped through self-harm for a long time. When I started the placement process with her in her junior year of her bachelor’s in social work program, she became incredibly anxious. She started have debilitating panic attacks that took her away from the classroom and impeded her quality of life. She reached out to me embarrassed about her mental health and needing to ask for an extension on an assignment. In our conversation I mentioned to her that if she had the stomach flu there would be no question of her asking for an extension. I said that she was having an «emotional flu» and we should react to it and treat it the same way as if she was having a physical illness. She laughed and calmed down and said I was right. Her biggest worry was that we would assume something in class had triggered her and we would not think she could continue as a social work major. She stated that she would rather suffer in silence than reveal some of the deep wounds that led her to social work and likely impacted her mental health. My goal as her professor was to view her past trauma, not as skeletons in her closet, but as gems that brought her to where she was and could be used to empower her to find her purpose in being a social worker. I encouraged my student to get the mental health support she needed. In time and with the right medication, she got better. She finished the semester successfully. She interviewed for her field placement and landed a prestigious internship in child welfare. She is thriving her in field placement and making meaningful contributions to her field agency and helping her clients through their challenging times. This student truly demonstrates the essence of the concept of Post Traumatic Growth. My student had been through hell and back, but she was stronger from it. She survived and she is excelling in her pursuit of education and happiness. She is learning to accept her past and hold hope for her future.

As a social work educator, the prevalence of adverse childhood experiences and their impact on the mental health of social work students is not surprising. However, I grapple with understanding how to manage these issues in the educational setting without crossing any significant boundaries or playing a dual role of educator and therapist. For example, a student I worked with in my role as field coordinator endured her own trauma history being triggered in her field placement. She was an adult learner, in her late fifties, working full time at a grocery store and was in school full time. She was adopted at birth, suffered abuse and sexual abuse as a child. She endured significant domestic violence in her marriage. She had been doing great in her field placement first semester and then suddenly stopped going. She had also been exhibiting a hard time establishing clear boundaries with her clients and often self-disclosed her own history of trauma. Her field instructor told us that she wasn’t fit to be in the field and would no longer supervise her. I struggled with wanting to see my student succeed and then being the gatekeeper for our profession. She was a strong student in the classroom, and she had a good first semester in field. Do we just give up on her because her trauma history had been triggered and was impacting her performance in her field placement? It was her dream to be a social worker. When she was married, she was not allowed to get her college degree. One of the ways in which her husband controlled her was through money. In speaking with her she was terrified about how close she was to graduation and wondered did she really deserve to be where she was. We met with our student and her field placement several times to come up with a plan to get her through to graduation. First and foremost, she agreed to start seeing her therapist again. In addition, we developed a supervision plan involving her field placement but also us as her field educators that would get her through the end of the year. She ended up achieving her dream of being a college graduate and went on to get her Masters in Social Work degree. Reflecting on my students experiences has made me want to look at several things: 1) what is our role in higher education to better prepare our students through a trauma informed lens; 2) what do the students believe helps them achieve success in and outside of the social work classroom; and finally, 3) how do we effectively gatekeep to uphold the standards of the social work profession.

It is clear from the data and the stories I’ve shared that our profession attracts the «wounded healer» and that we need an innovative path on how best to support our students that have experienced trauma, mental health and/or substance abuse. While there is a significant amount of literature about trauma informed practice and trauma informed pedagogy, I wonder how often it trickles down into the curriculum and pedagogy in social work classrooms. Do we truly practice what we teach?

Trauma Informed Teaching

In the social work classroom trauma can present educators with a serious dilemma; «how to balance their primary mission of education with the reality that many students need help in dealing with traumatic stress to attend regularly and engage in the learning process» (Ko et al., 2008, p. 398). Thus, it is important to consider potential wounded healers in our classroom as we design curriculum to ensure that our students have access to the educational, emotional and social supports they need to be successful in their pursuit of their social work degree. For example, students may need more support and training in self-care, boundaries surrounding self-disclosure and transference (Newcomb et al., 2015). In addition, these individual students may demonstrate resilience that needs to be further cultivated in the classroom through trauma informed pedagogy (Grant & Kinman, 2012). To be trauma informed is to understand the ways in which «violence, victimization and other traumatic experiences may have impacted the lives of individuals and to apply that level of understanding to system designs and provisions of services, so they accommodate survivors needs and are consonant with healing and recovery» (https://socialwork.buffalo.edu/about/trauma-informed-human-rights-perspective/what-is-trauma-informed-teaching-.html). In practice, we infuse a trauma informed lens to help survivors endure and accept their challenges and ultimately to empower them. In the classroom we should mirror how we practice and approach our students with the same lens to help them transform their own personal histories and fully engage in the learning process.

Jung focused on the transformative process a wounded healer goes through to feel «enlightened by the experience of trauma or adversity» (Newcomb et al., 2015). For some social work students, the classroom may be where this transformation occurs. Thus, social work educators need to be mindful of the role adverse childhood experiences may play on our students learning experiences and ensure they provide a safe space for transformation to occur. To achieve the latter, we should pull from the five core tenets of a trauma informed perspective which includes safety, trustworthiness, choice, collaboration, and empowerment (Dill, 2019). These tenets should be engrained in our pedagogy and embedded across the curriculum. While all tenets are important, creating a sense of safety and ease in the classroom for students to learn is essential especially when we include content involving trauma in our curriculum (Carello & Butler, 2015).

A fundamental objective of Trauma Informed Teaching is to «make every effort to minimize the risk of inadvertent re-traumatization, vicarious traumatization, or wholly new traumatization, each a risk when teaching about trauma» (Carello & Butler, 2015). A major task as educators is to remove any potential barriers to learning without having to remove or minimize content that may be traumatic, sensitive or difficult from the curriculum (Carello & Butler, 2015). We want to increase our student’s sense of resilience while also reducing possible risk to students through sensitive material in the classroom. Some suggestions from the literature as to how to do the latter are to increase student awareness about the importance of self-care, incorporate mindfulness activities into the curriculum, balance exposure to traumatic material with transparency and authentic conversations, actively listen and respond to your student’s feedback and questions (Carello & Butler, 2015). Frequent check-ins throughout the classroom discussion can provide invaluable time for students to reflect on how they are reacting to the course content. It is also important to facilitate support both in the classroom and outside. For example, my senior social work majors started a Peer Mentor Group to feel more connected during the Covid-19 Pandemic. This group became a place where students could share and validate each other’s concerns. They also maintained this group throughout their senior year field placements which was tremendously helpful in their adjustment to managing both their field placements and coursework. Other suggestions from the literature include, being mindful of power imbalances and maintaining effective teacher-student boundaries (Carello & Butler, 2015). This is particularly important especially because as social work educators we must balance our roles of teacher, social worker and gatekeeper.

This is an important time as social work educators and social workers for us to reflect on why we chose this career path, what we want to achieve and how we want to get there. As more evidence emerges that we are in fact a profession inclusive of wounded healers, we need to consciously craft our lesson plans, check in more diligently with our students and be mindful of both their strengths and limitations in the classroom. We have to use those skills we learned to actively listen, assess the person in context of their social environment, and empower our students to be brave, speak up, trust their strengths, know their limitations and be able to assess whether or not their plan A is the best way to pursue their dreams or whether plan B would be a better choice through effective gatekeeping.

The Role of Gatekeeper

Gatekeeping is an essential role we play as social work educators. Since the inception of our profession, social work educators have agreed that «gatekeeping is a fundamental ethical obligation» (Sowbel, 2012). While we all agree gatekeeping is important, it is also hard and raises a great deal of ambivalence especially as schools of social work balance the demand and need for high enrollment but also ensuring their social work students are both emotionally and professionally ready to tackle the challenges they may encounter in the field. Gatekeeping is defined as «the professional practice obligations of social work educators to ensure that graduates are fit to practice social work by screening out unqualified students who may cause harm to their clients» (Sowbel, 2012). Unfortunately, many social work educators will encounter a student or students that are not ready emotionally or professionally for the field. There are also students that cannot complete their coursework or program requirements due to re-traumatization (Carello & Butler, 2015). Careful screening pre-admittance is essential and checking in with students throughout their coursework can help prevent a student from failing or from experiencing emotional harm.

For example, I had a student that was brilliant and insightful in the classroom and also had a significant trauma history. She had been in therapy for years to deal with her trauma and believed she was in a good place emotionally and educationally. However, when she started her field placement in a hospital setting, she started having panic attacks. We changed her placement to give her an opportunity in an agency with less trauma exposure. She started having migraines and missing field in her new placement. Ultimately we met and she said she didn’t feel ready for her field practicum because she was still working through her own trauma. We agreed that it would be best for her to withdraw from the program. She continued to pursue her college degree in a different major and successfully graduated from college. This was not an easy decision for her to make as student, or for us as educators. She chose social work because she wanted to help people in the same way a social worker had helped her. But the timing wasn’t right for her and we had to help her accept that and find a different avenue for her to pursue until she was ready to explore social work as a career again.

The student situations I have presented in this paper are not unique to the university I teach. The data presented demonstrates that as social work educators we need to create a classroom setting where both academic and personal transformation can take place so that we can advance strong social workers for the next generation. Our ultimate goals as social work educators should be to minimize any possibility of re-traumatization and improve educational outcomes and success towards completion of the social work degree (http://socialwork.buffalo.edu/content/dam/socialwork/home/teaching-resources/1-1-Carello-rationale-for-TI-definition-principles-objectives.pdf). In order to do this we need more training, time and support from higher education institutes to truly implement trauma informed pedagogy at both the undergraduate and graduate levels. We also need the skills, tools and space to truly turn social work academia into a transformative process for all students. The latter should encompass the fact that we are social work educators not therapists and we have to be clear about our boundaries and role.

Conclusion

Each year my cohort of students amazes me with their ability to transform the knowledge they have gained in the classroom into practice at their social work internships. Every year we have a few students that struggle with feeling triggered and re-traumatized in their field placements. We also have students that are challenged with the demands of being in school fulltime, at their internship sites and working full time to support their families. Each year I am reminded by my students how far they have come and how far they will go with the right supports in the classroom and in their internships. My goal as their professor is to learn from them about what works and what does not in the classroom and in their field placements. I have found the latter to be the biggest gap in the literature. While there is a multitude of research on field education and trauma informed pedagogy, the research is missing the student’s point of view on how we can better support their social work education. I want to hear from the students directly on what we can do as their social work educators to support their educational experience no matter what their history. The next time I write, I plan to with the feedback and insight from my students about their lived experiences. I want to hear through their voices how those lived experiences transformed them and helped them find their way to social work and what we can do as educators to ensure their success.

In addition, I want to explore more deeply the gatekeeping role that is so crucial for us to play as social work educators. Not just anyone can be a social worker. We are a profession that is bound by a code of ethics and core set of values to help enhance functioning for individuals and promote social justice. As social work educators we are in an essential position to maintain the dignity and professionalism of social work. I look forward to delving deeper into this role of gatekeeper and how best to support educators, who like me, are probably challenged with walking on a tightrope of teaching social work and doing social work in the classroom. We have to work together with our students to ensure we are providing the best education, training and support for future social workers.

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