Taking Care of Yourself

From an Aboriginal and Torres Strait Islander¹ perspective health and wellbeing is more than just about the physical wellbeing of the individual. It is also about the social, emotional and cultural wellbeing of the whole community [10985] . For most Indigenous alcohol and other drug (AOD) workers, their main aim is to improve the health and wellbeing of their communities, with whom they feel unified in heart and spirit [28152].

In seeking to improve the wellbeing of communities, it is also important for workers, their supervisors and managers to understand what they (i.e. the worker) can do to improve their own wellbeing by reducing stress and burnout. Each worker needs to recognise how they respond to stress in their work role. This is different for each person.

Understanding the factors and events that trigger stress and applying strategies to lower stress levels is essential for worker wellbeing.

What is work-related stress and burnout?

Stress occurs when people feel they cannot cope with the demands placed upon them. Work stress refers to what happens when work demands get too much over a short-term period.

Burnout is different to stress (but it may include signs and symptoms of stress). Burnout is a longer-term process where workers do not function well at work and develop negative and cynical attitudes towards clients and work in general. Stressful working conditions and job demands can result in worker burnout over time.

When people are burnt out they:

• feel emotionally exhausted (feeling overextended and emotionally and physically drained)
• have a negative, detached or cynical view of their work
• feel like they are not accomplishing much at work
• feel they are stupid or that nothing they do has any effect [28152].

Stress and burnout can lead to:

• reduced job satisfaction
• lower job performance (quality and quantity of work)
• an increase in being absent from work and staff turnover
• reduced commitment to work and the organisation [26602].

Stress, burnout and Aboriginal and Torres Strait Islander alcohol and other drug workers

Workers in health and welfare jobs often have high levels of work-related demands and stressors. They are more likely than other workers to experience stress and burnout.

Working in the AOD sector can be stressful and challenging but also rewarding [38246]

For many Aboriginal and Torres Strait Islander AOD workers, working in the AOD sector may be even more challenging for a range of reasons [28152]. There are 10 major sources of work-related stress which affect Aboriginal and Torres Strait Islander AOD workers, listed in Table 1.

Table 1. Sources of work-related stress
Workloads	heavy workloads clients with a lot of unmet needs.
Expectations	workers often want to do their job very well but there are also complex community obligations that workers need to fulfil.
Boundaries	many workers feel the need to be available 24/7 as part of their cultural obligations. As a result it can be difficult to ‘draw the line’ around work lives.
Recognition, respect and support	workers may not get the recognition or respect they deserve or they may be solo or isolated workers without enough support.
Working conditions	working conditions can be hard and stressful, especially among workers in rural and remote settings.
Racism and stigma	there is a high level of stigma attached to AOD work just as there is about the Aboriginality of the clients and the workers. Co-workers and the mainstream community may also be racist.
Complex personal circumstances	many workers have complex home lives themselves, such as being single parents or having dependent children, elderly and other family members. Many workers have had significant losses, domestic violence problems, and previous problems with AOD. Family members may also be AOD clients.
Loss, grief and Sorry Business	deaths at a young age, including suicides, happen often in Indigenous communities. Mainstream bereavement leave may not be enough. Co-workers and managers may not realise the importance of ‘Sorry Business’ and loss overall.
Culturally safe ways to work	many workplaces do not understand about Indigenous ways of working. This can cause conflict and clashes with mainstream co-workers and can have bad effects on the health and wellbeing of both clients and workers.
Funding, job security and salaries	short term funding and/or short term jobs with low salaries can lead to high stress levels and high turnover rates.

Source: Roche A, Nicholas R, Trifonoff A, Steenson, T (2013) [26602].

Strategies to address stress and burnout

The best strategy to prevent (or reduce) stress and burnout is an approach that focuses on both:

• organisational responses
• individual responses.

Individual stress reduction strategies should be used in conjunction with organisational strategies to reduce stress, not in isolation [28152].

What can Aboriginal and Torres Strait Islander alcohol and other drug workers do to reduce stress and risk of burnout?

Individual workers can do a lot to manage their stress and reduce risk of burnout.

Cultural backgrounds

Many Aboriginal and Torres Strait Islander people have overcome extraordinarily difficult experiences and have gained great strength and resilience from their cultural backgrounds.

Key elements in maintaining worker wellbeing include:

• having close family bonds
• telling and hearing cultural stories
• spirituality.

Connections to community

Doing work that allows workers to keep and strengthen their links with their communities is an important stress management tool for many workers. Being able to give and receive support from their communities is extremely important to worker wellbeing.

Laughter

Laughter is a helpful way to remain positive and resilient. Humour can also be used within the workplace as a way to manage distressing events and contain minor irritations.

Having realistic expectations

Developing an understanding of what can and cannot be done, and being aware that it is not possible to help everyone, is essential for worker wellbeing. Developing realistic expectations can reduce the stress on Indigenous AOD workers. Recognising stressful situations that are likely to occur as part of Aboriginal and Torres Strait Islander AOD workers’ roles can help reduce stress when these situations do arise.

Prioritising work tasks

Prioritising the jobs to be done at work is important to reduce stress, particularly where workloads are overwhelming. It is important to learn techniques and strategies to give work tasks that are most important at the time they need to be attended to. Knowing how to prioritise tasks is a key way to keep on top of the demands and expectations from communities, peers and managers.

Work/life balance

Work/life balance is the relationship between work and other commitments in workers’ lives and how they impact on one another. Many Aboriginal and Torres Strait Islander AOD workers struggle to balance work and the responsibilities of caring for children, community and kin. There is no ideal work/life balance. Everyone is different and the ‘right’ balance may change as commitments change. Flexible work arrangements help to manage work and life demands, for instance by allowing employees to work in patterns and places that fit their personal commitments.

Enjoying the successes

Working with clients, particularly one-on-one, and helping them to achieve their goals is a major source of worker satisfaction. Seeing clients who previously had AOD problems living, working, and participating in community activities is rewarding and can balance out the stress and demands experienced by workers. Focussing on and sharing successes, no matter how small, is very important.

Table 2. Things that Indigenous AOD workers can do to reduce their stress
Traditional things	take time out to participate in traditional activities go home to community practice your spiritual understanding of the world.
Recreational things	take time out to participate in an enjoyable activity listen to music meditation, yoga, breathing exercises go for a walk with a friend take the dog for a walk have a regular massage.
Social things	share knowledge learn new things have a close personal support network spend time with family visit friends eat well, go out for dinner laugh.
Domestic personal things	take a nap turn off the phone, lights, TV; spend time alone do not answer the door enjoy a movie or favourite TV show go for a long drive gardening have regular medical checks practice healthy living (i.e. do not smoke, drink, use illicit drugs).
Work-related things	have a coffee and debrief informally with work mates have a routine take one day at a time consider things from another perspective accept your limitations look forward to the end of the working day; do not take work home.

Source: Roche A, Nicholas R, Trifonoff A, Steenson, T (2013) [26602].

What can organisations do to support worker wellbeing?

Organisations can support workers by addressing aspects of the work situation that cause stress. This could be things like:

Regularly consult with staff about their workload

• make sure staff are not overloaded
• ensure workloads are shared evenly
• involve staff in decision-making on issues which impact their work.

Understanding Aboriginal and Torres Strait ways of working

• have flexible working arrangements to allow workers to balance work, family and community commitments
• recognise the importance of connections and obligations to land, community and kin
• consult widely with communities.

Provide role clarity

• Better job descriptions let workers know what their roles are within their organisations.

Supervision and support

• clinical supervision – involves an experienced worker helping a less experienced worker to develop their clinical skills by providing guidance and support. This is an important way of preventing and managing stress. For Aboriginal and Torres Strait Islander AOD workers, this needs to occur in an Indigenous specific and culturally safe way.
• debriefing – helps workers to carefully reflect on stressful events. This includes factors such as what led to the event, the worker’s reactions to the event and how future stressful events can be prevented. It is important for organisations to provide appropriate debriefing that best suits their workers.
• mentoring – is where more experienced workers (mentors) work with less experienced workers. It provides a safe and supportive way to help the person being mentored, learn to manage stressful and hard situations. Mentoring also helps develop problem solving skills to address issues and problems that happen in the AOD field.

Career paths

• limited promotion opportunities for Aboriginal and Torres Strait Islander AOD workers can make it difficult to attract and keep staff. It is important to provide career paths for staff and to create senior staff positions that can be attained.

Salaries

• Aboriginal and Torres Strait Islander AOD workers do difficult and valuable work and deserve appropriate salaries. Equivalent salaries for staff from government, community controlled and non-government health services are important.

Team and co-worker support

• team and co-worker support is particularly important for Aboriginal and Torres Strait Islander AOD workers, especially those working in remote areas. It is recommended that Indigenous appointments are not made in isolation. This is especially important for young or new workers.

Qualifications and training

• Aboriginal and Torres Strait Islander AOD workers and their managers may need additional and ongoing training to allow them to do their jobs well. Improved training and advanced skill development helps reduce stress levels among workers.

Where to get more information on Aboriginal and Torres Strait workforce support

The Australian Indigenous Alcohol and Other Drugs Knowledge Centre maintains a range of resources to support Aboriginal and Torres Strait Islander AOD workers in their practice. For more information please click on the links below:

Drug and alcohol courses

• a comprehensive listing of current drug and alcohol courses relevant to Aboriginal and Torres Strait Islander AOD workers.

Conferences, events and workshops

• a range of professional development opportunities in each state.

Handbook for Workers

• the Handbook for Aboriginal alcohol and other drug work provides practical information to guide AOD workers in their day-to-day work. Each chapter includes detailed information on approaches to alcohol and drug work, ranging from clinical guidelines and general principles of counselling to information on specific drugs.

Aboriginal community controlled health organisations also offer a wide variety of workforce support options, including workforce development units, health worker networks, accredited training courses and newsletters and magazines. Contact your relevant state or territory’s peak community controlled health organisation for more information about what is available in your region.

Table 3. List of Aboriginal Community Controlled Health Organisations in Australia
Australian Capital Territory	Winnunga Nimmityjah Aboriginal Health and Community Services
New South Wales	Aboriginal Health and Medical Research Council of New South Wales (AH&MRC)
Northern Territory	Aboriginal Medical Services Alliance Northern Territory (AMSANT)
Queensland	Queensland Aboriginal and Islander Health Council (QAIHC)
South Australia	Aboriginal Health Council of South Australia (AHCSA)
Tasmania	Tasmanian Aboriginal Centre Inc.
Victoria	Victorian Aboriginal Community Controlled Health Organisation (VACCHO)
Western Australia	Aboriginal Health Council of Western Australia (AHCWA)

Information in this section is based on the Indigenous alcohol and other drug workers’ resource kit [26582] produced by the National Centre for Education and Training on Addiction in consultation with Aboriginal and Torres Strait Islander alcohol and other drug workers.

Endnote

¹The terms Aboriginal and Torres Strait Islander and Indigenous are used interchangeably throughout this document. We understand that some people have a preference for using one term over the other and we have used the terms interchangeably to be sensitive to these differing perspectives.