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Family and Children's
Resource Program

Vol. 22, No. 2
April 2017

Managing Anxiety's Influence on Decision Making

Child welfare decisions can provoke real anxiety in those who must make them. It's easy to see why: these decisions can have serious consequences. Although understandable, this is a problem, because anxiety can interfere with the quality of our decisions. What can child welfare professionals do to manage the fear that sometimes comes with decision making?

Sources of Our Anxiety
Social workers have identified many sources of anxiety that influence their decision making. These include concern about making the wrong choice, worries about the responsibility (both legal and moral) that rests on their shoulders, fear of shame and blame from other workers and other professionals, and concern about being accused of doing something wrong or bad (Taylor, 2008).

How social workers are perceived by society can also be an issue. Many feel the public has an overall negative image of their work. In focus groups social workers have described being afraid of negative reactions from the community, being ostracized by friends or family, and being seen as a bad person (Smith, 2003).

Anxiety's Impact
Anxiety can interfere with our ability to make good decisions. High levels of anxiety have been shown to affect the specific areas of the brain needed for complex decisions. In other words, the more anxiety you have about a decision, the harder it will be to make that decision using all the information at your disposal (Bergland, 2016).

Threats in the field can also hinder our thinking. Researchers looked at cortisol levels in social workers interacting with a confrontational parent. Facing this threat, especially when it was unexpected or new, workers' cortisol levels rose, invoking the flight-fight-or-freeze response (LeBlanc, 2012). Increased cortisol levels have been shown to impair verbal, social, and declarative memory and selective attention--all of which we need to make good decisions (sources cited in LeBlanc, 2012).

Some of the defenses we deploy to help us manage anxiety can also interfere with decision making. For example, social workers have been shown to use projection (blaming others), habitual or ritualized processes, and splitting (creating silos so no one team or department holds the burden). While these strategies may help us cope in the moment, they can also prevent us from seeing the complexity of the situation or blind us to the limits of our knowledge and control (Taylor, 2008).

To manage anxiety you must first know you are experiencing it. Self-awareness is an active process that involves knowing what anxiety looks like for you (e.g., sleeping less, eating less/more, difficulty concentrating, rapid heart rate, etc.) and then taking steps as soon as you see the signs.

Here are some suggestions from Avinadav (2011) for managing anxiety through self-awareness and emotional regulation:

  • Identify the source of the anxiety; explore what you are afraid of.

  • Use strategies to reduce anxiety in the moment, such as deep breathing exercises or mindfulness body scans (Berceli & Napoli, 2006).

  • Take steps to modify your thinking about the situation:

Recognize. Identify when your thinking goes to the negative or worst possible outcome.

Evaluate. Consider whether the situation is really so bad. Are there opportunities you didn't see at first because you jumped to being negative?

Modify. Reframe the negative aspects of your original reaction to find neutral or even positive aspects of the situation at hand.

(Note: North Carolina child welfare professionals can learn more about these techniques in the courses [one for line staff, one for supervisors] on secondary traumatic stress offered through

Tough decisions are part of child welfare. However, if we put effort and energy into understanding the stressors workers are under and help them build practical skills for managing that stress, our difficult decisions may become more manageable.

Supervisors Can Help

Supervisors are in an excellent position to help child welfare social workers learn to prevent anxiety from interfering with the decision-making process--or to exacerbate the problem. After all, they are a big influence on employees' day-to-day experience. One study (Gibbs, 2001) found that in units where workers experienced supervision as a kind of surveillance, workers reported higher levels of anxiety. Yet supervisors can also have the opposite effect, fostering an organizational climate that emphasizes emotional support and professional development.

One way to do this is by devising training simulations explicitly focused on making decisions while using the kind of strategies outlined in the article above. The idea is to give workers a chance to practice the skills they need to manage stress while making tough decisions in a controlled situation. These simulation sessions can then be followed up with supervisory guidance, feedback, and support in the real world (Kleespies, 2014). This type of preparation could have a positive impact on outcomes for children and families, and on worker retention.

References for this and other articles in this issue