Long regarded for its ability to create safe, trauma-informed environments, the Sanctuary model has been applied to health and human service organisations for over four decades.

The Sanctuary model also holds transformative potential for workplace wellbeing, which has become a focus for many organisations and companies over the last decade - even more so following the COVID-19 pandemic.

Across sectors and the world, workplace wellbeing and health remains an important and growing concern. Over a decade ago, it was argued that work stress had reached epidemic proportions within modern western societies.

A study conducted in the UK found that around half a million people experience work-related stress at a level that they believe is making them ill, and up to five million people feel “very” or “extremely” stressed by their work (Johnson, 2005).

This study identified several industries where above average levels of stress are experienced including healthcare, social work and other community services. Closer to home, WorkSafe Australia cite welfare and community workers as the second most at-risk of work-related mental health disorders.

A 2022 report from The Committee for Economic Development of Australia forecast a doubling of the number of mental health worker compensation claims by 2030.

What is needed, and increasingly expected from employers is the implementation of organisational-wide wellbeing strategies. There are three factors that are often identified as contributors to stress and unhealthy workplace cultures. When deeply embedded, Sanctuary can act to mitigate these.

1. Emotional Labour and Vicarious Trauma

To work in the human services or care sector you need to engage in emotional labour and successfully regulate your emotions. Research shows that emotional labour increases the likelihood of burnout. Combined with unchecked emotional demands, emotional labour can lead to a sense of being overwhelmed, disconnected or having a desire to leave the role or profession.

Staff working in human services are also shown to be at risk of experiencing vicarious trauma when exposed to the trauma, abuse or violence experienced by others. Vicarious trauma has a negative effect on the helper and can result in feelings of distress, hopelessness and potential mental health problems.

The Sanctuary model offers tools that focus on identifying, understanding, and responding to trauma, and can provide an organisation with strategies to proactively mitigate the risk of vicarious trauma.

Effective supervision is central to Sanctuary, enabling many aspects of the model, and directly addressing emotional labour and vicarious trauma. Research conducted by Riely and Weiss (2016) found that supervision played a critical role in helping staff manage the varied emotional demands of their role.

Organisations implementing Sanctuary are encouraged to measure both the completion rates for supervision across their workforce, and quality of supervision that is occurring. MacKillop Family Services, a Sanctuary organisation, places a high value on supervision. MacKillop sees this practice as a way to proactively manage the impacts of emotional labour and vicarious trauma, encourage civility and emotional intelligence and support staff to align their role with the broader purpose of the organisation.

Utilising other aspects of the Sanctuary model such as safety and self care plans, community meetings and enacting social responsibility, can moderate vicarious trauma. Individuals become increasingly aware of their own resilience at any given time, and peers play a role in providing social support.

Reduced work cover claims, staff turn-over and return to work after psychological stress claims can all help an organisation to understand the contribution of Sanctuary. Organisations may also decide to use the professional quality of life survey to identify where staff are at risk of burn-out or deriving fulfilment from their role at any given time.

2. Incivility and Bullying

In any environment where workplace wellbeing can be negatively affected by stressors like emotional labour, the risk of conflict and workplace bullying is high.

In a study conducted among allied health professionals in Australia, 24 per cent of respondents reported that they had experienced bullying occasionally to frequently over a period of six months (Ciby, 2015).

Incivility is a counterproductive behaviour that is less intense than bullying but is a common precursor to psychological injury that results from bullying. Both policy and authentic leadership are key to reducing incivility.

It's important that leaders find the tools to foster emotional intelligence amongst their teams, identify and address episodes of incivility and have clearly enacted policies that create a living culture of compassion. The Sanctuary model provides organisations with an overarching language and set of behavioural expectations that promote emotional literacy and can moderate and even mitigate against a culture that enables bullying.

At the heart of Sanctuary is the intent to create a therapeutic environment in which clients and staff can overcome adversity and trauma. The focus on culture change is best demonstrated through the Sanctuary Commitments of Non-Violence, Open Communication, Growth and Change, Social Responsibility, Cultural Humility (Australia-specific), Democracy, Social Learning and Emotional Intelligence. These commitments are designed to have a specific focus throughout the year, and to be embedded in team discussions, established as ground rules for difficult conversations, and role modelled by leaders within the organisation and with external stakeholders.

A core Sanctuary tool, community meetings, place the person at the centre, strengthening social networks, creating a routine of care, and engaging each role in attention to wellness. This tool enables role modelling by leadership and combats incivility.

Sanctuary's trauma-informed question of 'what happened to you?' lifts employees' engagement from 'what's wrong with you?!' to a more respectful expression that allows for peers to have a 'bad day', and in doing so, prioritises human dignity. This approach has informed the HR functions of MacKillop Family services, with business partners seeking first to understand what has happened to employees where under-performance or transgressions have occurred. While this does not mitigate the need to address issues, it has created a more effective intervention as HR business partners engage with emotional intelligence.

Effective supervision allows for stressors and hardships experienced by staff to be identified and addressed early. The commitments to Open Communication and Social Responsibility mean tangible actions must be taken to cultivate wellness in the individual and the workplace.

3. The challenge of attracting and retaining staff

Data released by the Australian Bureau of statistics in 2022, showed that health care and social assistance topped the list of sectors having experienced job change, with 12.2% of the workforce electing to change roles.

For residential care an attrition rate of around 25% remains common, causing strain on training, quality, and continuity. Where organisations can provide a point of difference, such as clear and effective wellbeing strategies, attracting and retaining suitable staff may become easier.

Using Sanctuary to position an organisation as an employer of choice, creates an implicit understanding that organisations who cultivate workplace wellbeing don't just care for their clients, they care for their staff.

Applicants seeking roles with MacKillop Family Services frequently cite Sanctuary as a reassuring and attractive factor. While their knowledge of the model is often limited, the presence of a unifying, trauma-informed framework that emphasises staff wellbeing is identified as a draw card.

Sanctuary intentionally seeks to create psychological, physical, cultural, moral and social safety for employees, with these domains given specific attention during induction. This shared language around what constitutes a healthy and safe work environment is underpinned by the Sanctuary Commitments. Once established in their role, new employees have the tools to address challenges that can compromise belonging and safety. In MacKillop's 10-year history of undertaking external cultural surveys, the Sanctuary model is consistently listed as one of the top reasons staff feel engaged in the organisation and remain in role.

Using the S.E.L.F tool (Safety, Emotion, Loss, Future) during times of uncertainty, such as restructures, or local and global disasters, helps staff to find collective resilience amidst change. It also represents a key team and individual resource that promotes agency to shape the future.

These approaches to workplace wellbeing are unique to Sanctuary and relay an organisational commitment to and valuing of individual staff.

Return on investment measures may include monitoring rates of staff turn-over, use of casualised staff, and information obtained in exit interviews. Where Sanctuary is well-known and embedded, organisational-wide cultural surveys should capture higher levels of staff engagement. This was the case with Anglicare NSW/ACT and MacKillop Family Services. Both organisations scored 76% in response to the statement: This organisation is truly a great place to work. This followed two years of the COVID-19 pandemic and compares to the sector benchmark for health and community services of 64%.

Sanctuary's whole of culture approach to safety and workplace wellbeing supports staff to form healthy communities and create a culture that prioritises safety at every level.

See the full list of Sanctuary resources and how they support workplace wellbeing here.

Written by Cameron Burgess, National Program Director, Sanctuary & Power to Kids.

Find out more about the Sanctuary model here

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