Is Self-Care Sustainable Without Structural Support? A Systematic Review of Self-Care Interventions

Abstract

Purpose:

Social workers navigate systemic stressors while managing self-care amid scant institutional support. The purpose of this systematic review is to critically examine the state of social work intervention research for self-care practices.

Methods:

This review includes empirical research articles focusing on self-care interventions in social work between 2011 and 2022 (N = 22).

Results:

All self-care interventions focused on modifying individual behaviors, attitudes, and knowledge.

Discussion:

Most (83%) research on self-care interventions focused on mindfulness, which tended to be associated with improvements in mindfulness, distress management, and clinical self-efficacy. The remaining interventions tended to be associated with improvements in self-care attitudes, knowledge, practices, and wellness.

Conclusion:

Structural factors and socioeconomic privilege have been found to be predominant predictors of whether social work students, educators, and practitioners engaged in self-care practices, yet no interventions incorporated structural or institutional variables. Multilevel interventions addressing structural, institutional, and relational determinants of burnout are needed.

Despite structural factors driving stress, self-care conceptualizations tend to center a focalized lens (Barks et al., 2023) of self-care to include physical, emotional, spiritual, and psychological activities (Bloomquist et al., 2016). Self-care has been conceptualized as the actions people and organizations take to reduce stress and promote wellness, but its study has focused on individual rather than institutional factors (Bloomquist et al., 2016). Well-established research has demonstrated how role overload, chronically high-stressed workplaces, and burnout drive the need for self-care (Bride, 2007; Figley, 1995, 2002; Pyles, 2020). According to the National Association of Social Workers’ (NASW, 2021) code of ethics: “Professional self-care is paramount for competent and ethical social work practice. Professional demands, challenging workplace climates, and exposure to trauma warrant that social workers maintain personal and professional health, safety, and integrity” (Purpose of NASW Code section). However, self-care practices do not address the underlying institutional causes of social work wellness found at the mezzo and macro levels (Apgar & Parada, 2022).

A systematic review of barriers and facilitators to self-care practices for students, educators, and practitioners indicated that social workers with greater resources and privileges engage in more self-care practices (Barks et al., 2023). As such, facilitators of self-care are likely situated at institutional and system levels. Social workers engaged in self-care practices were more likely to have access to greater sociopolitical resources. For example, they were more likely to be more established and have more experience as students, faculty, or practitioners; they were more likely to be White, heterosexual, married, healthy, work fewer hours, and have higher socioeconomic professional status and privilege (Barks et al., 2023), indicating current conceptualizations of self-care may not be accessible and contextually and culturally relevant to all social workers. Extant approaches and conceptualizations of self-care have been critiqued for reflecting and replicating Western Europe and White middle-class values applied as universal values (Yakushko & Blodgett, 2021). Those with (a) greater financial stability; (b) post-MSW experience and educational attainment; (c) compassion satisfaction, the positive feelings one experiences from doing one’s work well, self-compassion, and positive perceptions of self-care; and (d) positive physical and mental health predicted greater engagement in self-care practices (Barks et al., 2023).

Intervention research on self-care in social work remains in its infancy and has focused on individual behavioral self-care strategies rather than institutional or structural responses (Barks et al., 2023). A recent review on barriers and facilitators to self-care indicated barriers were largely structural and institutional—long hours, a lack of support, and unrealistic demands and expectations were primary self-care barriers (Apgar & Parada, 2022; Barks et al., 2023). Role overloads across personal and professional spheres were barriers to self-care practices, whereas institutional self-care events and activities during the workday, along with collegial relationships, supervision, mentorship, and family and social relationships, promoted the engagement in self-care practice (Barks et al., 2023; Diebold et al., 2018). Despite structural or institutional constructs being primary determinants affecting the ability to engage in self-care, no research examined these factors explicitly (Barks et al., 2023). The sole systematic review that could be identified focused on self-care interventions and included only four studies focused on students—all of which were mindfulness interventions (Griffiths et al., 2019). Mindfulness may help self-regulation but does little about working conditions, long hours, and structural and organizational inequities (Doran, 2018) identified as key barriers to self-care practices (Barks et al., 2023), indicating a mismatch of the ability of interventions to address underlying causes. Despite the social workers’ ethical code to prioritize the well-being of the client, with no focus or emphasis on the well-being of the social worker (Burghardt, 2021), self-care and its practices have become a social justice issue in which structural conditions undermine the ability of social workers to engage in and maintain sustainable self-care.

Purpose

Given the mismatch in self-care framings and their sociopolitical barriers and facilitators, Hillock and Profitt 2007 recommend critical and structural self-care approaches. Such approaches integrate self-regulation and personal wellness, transforming systems of domination and holding them to account for perpetuating distress (Hillock and Profitt 2007). The purpose of this systematic review is to analyze intervention research related to self-care in social work critically. This review builds upon key structural facilitators and barriers identified in past research (Barks et al., 2023) to critically analyze the state of self-care intervention research in social work. Because intervention research in self-care is relatively new, with limited studies available using randomized control trials and other designs testing efficacy, this review aims to provide a broad overview of the state of existing self-care intervention research. This overview of the current state of research takes priority over deep examination of study design or methodological rigor, which will be more relevant as the field develops over time, as is the case for more established fields of study.

Given the nascent state of research, we focus broadly on the available research on self-care interventions across social work with students and professionals. This review provides a foundation to identify gaps and glean promising directions for future self-care intervention research to further the field. The scope of empirical research defined for this review is limited to published peer-reviewed journal articles reporting results from primary data collected on intervention research on self-care related to social work students and professionals. We identify empirical research to answer the over-arching question: What is the state of self-care intervention research in social work? We separate this investigation into (a) intervention research with pre- and posttest data and (b) experimental intervention research with primary data but no comparison data.

Method

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA, 2023) guidelines for systematic reviews, the scope of this systematic review includes empirical intervention research articles focusing on self-care and social work between the years 2011 and 2022. This review is limited to those research studies collecting primary data on self-care intervention. These include (a) studies with pre- and posttest intervention data, comparing baseline to postintervention changes in outcomes and (b) preexperimental intervention research designs, where evaluative intervention data were collected, but no data were collected to allow for pre- and posttest comparison of changes in outcomes over time. Because it has been covered in past research, this review excludes empirical research predicting facilitators and barriers to the use of self-care practices (Barks et al., 2023).

Given that self-care intervention research is relatively recent, articles were not limited by date. The final articles ranged between 2011 and 2022. We used the following search terms to identify peer-reviewed articles: “social work” AND “self-care.” Two individuals independently searched a variety of social science and health-related databases for relevant articles, including Academic Search Complete, APA PsycArticles, APA PsycInfo, EBSCO, The Educational Resource Information Center (ERIC), JSTOR, Psychology & Behavioral Sciences Collection, ProQuest–Applied Social Sciences Index and Abstracts, ProQuest–Sociological Abstracts, PubMed, Social Work Abstracts, SocINDEX with Full Text, and Springer Link. These 13 databases were searched from May 2022 to July 2022, and articles were entered into Excel spreadsheets. Manual searches of reference lists of relevant studies, based on eligibility criteria, were also conducted to locate additional-published literature. Inclusion criteria delimited the search to articles that: (a) peer-reviewed empirical journal articles, which collected primary data; (b) collected primary data on self-care interventions; and (c) addressed self-care and social work. In addition to studies with pre- and post-test data, we included interventions for which primary intervention data were collected, but no comparison data were collected. All aforementioned search strategies yielded a total of 36,802 articles. After applying the inclusion criteria of being empirical and appearing in peer-reviewed academic journals, 117 articles were identified and screened for duplicates based on the titles and abstracts, resulting in 112 eligible articles. Two external reviewers excluded 10 articles due to being editorials and calls to action. In addition, two articles were excluded for not being related to self-care. After a full text read, three additional articles were removed for failing to meet the aforementioned criteria. Articles conceptual (n = 58) in nature were excluded. The resultant 39 articles were divided into categories (i.e., empirical, related factors, ancillary, interventions, and descriptive). The authors and external reviewers independently reviewed all articles and ensured the inclusion criteria for intervention articles, including interventions with pre- and posttests and preexperimental interventions, were properly upheld. The resultant 22 articles met the inclusion criteria for the scope of this systematic review (Figure 1).

Figure 1.

Inclusion criteria process selection flowchart.

Results

Interventions

Twenty-two articles related to self-care interventions were identified and are structured by those with comparison data (i.e., preand posttest studies; n = 12) and preexperimental interventions (n = 10), which include some primary data but no control or pre- and posttest data collection. Tables 1 and 2 display a snapshot of results with the study information (i.e., sample, design, region, intervention type, and length) and key preliminary findings. Because research is relatively new, with all samples being convenience samples and a lack of control groups, all results are indicated as preliminary, with promising potential outcomes listed in Tables 1 and 2. All interventions focused on individual behaviors, and no interventions assessed structural variables. A majority (n = 17) of studies were situated in the United States, whereas the remaining were in the United Kingdom (n = 4) or Norway (n = 1).

Table 1.

Self-Care Intervention Overview: Pre- and Posttest Designs.

Citation	Study Information: Sample, Design, Region, Type, Length/Format	Promising Preliminary Outcomes
1. Gockel et al. (2013)	132 students Pre- and posttest design; nonrandom cohort control group Northeastern United States Mindfulness-based stress reduction 10 weeks	+ Self-efficacy and mindfulness
2. Gockel et al. (2019)	82 students Pre- and posttest design; longitudinal Northeastern United States Mindfulness-based stress reduction 8 weeks	+ Mindfulness + Reflection + Self-compassion + Self-efficacy − Distress − Anxiety/depressive symptoms Reduced challenges in self-efficacy
3. Greene et al. (2019)	19 students Pre- and posttest design Southeastern United States Mindfulness-based stress reduction 8 weeks	+ Mindfulness + Sleep − Distress/stress
4. Kinman et al. (2020)	26 practitioners Pre- and posttest design Southeast United States Mindfulness-based stress reduction 8 weeks	+ Mindfulness + Self-efficacy + Psychological flexibility + Compassion satisfaction
5. Lee and Himmelheber (2016)	56 students Pre- and posttest design United Kingdom Mindfulness-based stress reduction 12 weeks	+ Mindfulness + Nonreactivity + Journaling + Class engagement + Satisfaction
6. Maddock and McCusker (2022)	27 students Pre- and posttest design United Kingdom Mindfulness 6-week online	+ Mindfulness + Wellness
7. Maddock et al. (2022)	30 students Pre- and posttest design United Kingdom Mindfulness 6 weeks online	+ Mindfulness + Wellness + Self-efficacy − Distress, stress − Burnout − Anxiety/depressive symptoms
8. McGarrigle and Walsh (2011)	12 practitioners Pre- and posttest design Southeastern United States Mindfulness-based stress reduction 8 weeks Mindfulness	+ Self-care knowledge, values, and practice
9. Miller (2020)	40 students Pre- and posttest design Southeastern United States General self-care 8 weeks	+ Self-care knowledge, values, and practice + Satisfaction
10. Miller et al. (2019)	40 practitioners Pre- and posttest design Southeastern United States General self-care Half-day workshop	+ Self-care knowledge, values, and practice + Satisfaction
11. Napoli and Bonifas (2011)	48 practitioners Pre- and posttest design Southeastern United States Mindfulness-based stress reduction Seminar class	+ Mindfulness
12. Pyles et al. (2021)	26 practitioners Pre- and posttest design Southeast United States	+ Holistic + Mindfulness + Critical reflexivity − Structural barriers

Note. Study information (i.e., column 2) is listed in the following order: sample, study design, region, intervention type, and length/format.

Table 2.

Self-Care Intervention Overview: Preexperimental Designs.

Citation	Study Information: Sample, Design, Region, Type, Length/Format	Preliminary Outcomes
1. Curry and Epley (2022)	55 students and practitioners Qualitative, focus group Midwestern United States Critical reflexivity Course + supervision	+ Critical reflexivity + Self-reflection
2. Gockel and Deng (2016)	54 student Mixed methods Northeastern United States Mindfulness-based stress reduction 8 weeks	+ Mindfulness + Self-care + Self-efficacy + Satisfaction + Wellness − Distress, stress
3. Grise-Owens et al. (2018)	25 students Mixed methods Southeastern United States General self-care Critical reflexivity Semester course + supervision	+ Self-care + Satisfaction + Self-efficacy
4. Kwong (2016)	26 student Mixed methods Northeastern United States General self-care, journal, critical reflexivity Semester course	+ Self-awareness + Self-efficacy + Self-care + Satisfied + Student engagement
5. Lauridsen and Munkejord (2022)	29 students Mixed Methods Norway Critical dialogue circle workshops, critical reflexivity Three workshops plus follow-up	+ Self-compassion + Self-awareness + Emotional regulation + Mindfulness + Stress tolerance + Self-efficacy + Reflexivity
6. Lewis and King (2019)	45 students Qualitative United States General self-care Semester course	+ Self-care awareness, values, knowledge + Structural barriers
7. McCusker (2022)	16 students Qualitative United Kingdom Mindfulness-based stress reduction 8 weeks	+ Self-care awareness, values, knowledge
8. Micsky and John-Danzell (2021)	25 students Mixed Methods United States General self-care, participatory action, photovoice, journaling Semester course	+ Self-care awareness, values, knowledge + Wellness − Distress/stress
9. Moore et al. (2011)	22 students Qualitative United States General self-care/self-awareness, journaling Semester course	+ Self-care techniques (journaling) + Wellness + Distress/stress
10. Shannon et al. (2014)	17 students Qualitative United States General self-care, self-awareness, journal 15 weeks	+ Self-care awareness, values, knowledge − Structural barriers

Note. Study information (i.e., column 2) is listed in the following order: sample, study design, region, intervention type, and length/format.

Pre- and Posttest Interventions.

Table 1 displays 12 studies that identified the prevalence of self-care practices through primary interventions containing pre- and posttest data or comparison data (i.e., Gockel et al., 2013, 2019; Greene et al., 2019; Kinman et al., 2020; Lee & Himmelheber, 2016; Maddock & McCusker, 2022; Maddock et al., 2022; McGarrigle & Walsh, 2011; Miller, 2020; Miller et al., 2019; Napoli & Bonifas, 2011; Pyles et al., 2021). Students were participants in all but two studies (i.e., Kinman et al., 2020; McGarrigle & Walsh, 2011).

Except for two studies, all interventions focused on mindfulness as the primary area for change. Eight of the studies had an intervention developed from a mindfulness-based stress reduction (MBSR) program (Gockel et al., 2013, 2019; Greene et al., 2019; Kinman et al., 2020; Lee & Himmelheber, 2016; Maddock & McCusker, 2022; Maddock et al., 2022; McGarrigle & Walsh, 2011). MBSR is an 8-week program focusing on mindfulness practices of increasing emotional resilience, self-efficacy, reflective ability, psychological flexibility, and self-compassion. Variables were measured at least twice throughout the program, before and after the program, though additional measurement points could be taken. Results from the studies based on MBSR included a significant increase in the ability to be present, increase in empathy, increase in emotional self-efficacy, and an increase in overall engagement of mindfulness (Gockel et al., 2013, 2019; Greene et al., 2019; Kinman et al., 2020; Lee & Himmelheber, 2016; Maddock & McCusker, 2022; Maddock et al., 2022; McGarrigle & Walsh, 2011). Greene et al. (2019) found the following facets of mindfulness were statistically significant: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. Other results included a decrease in anxiety and stress and mindfulness skills being used outside the course (Gockel et al., 2013, 2019; Maddock & McCusker, 2022; Maddock et al., 2022).

Miller (2020) created an 8-week self-care course based on the CPIES (conceptualization, planning, implementation, evaluation, and sustainability) framework and had outcomes in the area of knowledge, skills, and values related to self-care. Miller et al. (2019) conducted a 3.5-h self-care workshop that focused on the knowledge and value of self-care through discussions, practical applications, and exercises in creating self-care plans and incorporating self-care in the field. Data were collected with surveys following the training, and results reveal significant increases in self-care knowledge and value associated with self-care (Miller et al., 2019).

Napoli and Bonifas (2011) explored self-care and mindfulness practices through a 16-week curriculum, The Quality of Life, which focused on different aspects of self-care and mindfulness, such as nutrition, exercise, relationships, and environments. This intervention supported participants in gaining mindfulness practice skills such as responding rather than reacting and empathy. These skills could be transferred to self-care approaches for improved overall health and well-being. Results indicated that increased use of mindfulness strategies was based on students’ ability to accept without judgment, act with awareness, and observe or enhance sensory awareness (Napoli & Bonifas, 2011).

Pyles et al. (2021) used the holistic engagement practice (HEP) model during a 2-day training focused on four skills through experiential learning: whole self-presence, whole self-inquiry, empathetic connection, and compassionate attention. The variables mindfulness, empathy, and professional self-care were measured by the Mindful Attention Awareness Scale, the Toronto Empathy Questionnaire, and the Professional Self-Care Scale, respectively. Results showed empathy scores stayed the same pre and posttraining, whereas there was a decrease in mindfulness score posttraining and an increase in professional self-care posttraining (Pyles et al., 2021). Results from the remaining four studies all had an increase in knowledge of self-care and self-care practices (Miller, 2020; Miller et al., 2019; Napoli & Bonifas, 2011; Pyles et al., 2021). All studies indicated the importance of mindfulness and self-care for overall well-being within the social work field, highlighting the benefits of some form of self-care for personal, emotional, and professional growth. No articles included findings where gender or demographics were statistically significant.

Preexperimental Interventions

Table 2 displays 10 studies that evaluated interventions but lacked comparison or no pre- and posttest data collection (Curry & Epley, 2022; Gockel & Deng, 2016; Grise-Owens et al., 2018; Kwong, 2016; Lauridsen & Munkejord, 2022; Lewis & King, 2019; McCusker, 2022; Micsky & John-Danzell, 2021; Moore et al., 2011; Shannon et al., 2014). All studies included students affiliated with social work, except one that included social work and nursing students and practitioners (Lauridsen & Munkejord, 2022). Two qualitative studies focused on MBSR (Gockel & Deng, 2016; McCusker, 2022). Gockel and Deng (2016) used the established MBSR curriculum focusing on mindfulness, breathing, body scanning, sounds, thoughts, meditations, and feelings but adapted the program to one-fifth of the hours to accommodate the students. Results indicated an increase in the ability to recognize and observe thoughts, feelings, and experiences, assisted in managing stress, and enhanced clinical skills. The course was viewed as support for overall well-being in learning self-care practices and viewed mindfulness as an integral part of professional development.

McCusker (2022) investigated MBSR with principles of participatory action research and focused on criticalness and reflexivity over multiple semesters. Semistructured interviews were conducted at three points: at the end of the 8-week program, at the end of the final placement, and 6 months after entering the practice field. Results indicated that critical mindfulness encourages self-care reflexivity within social work education and practice. Participants also noted changes to negative self-image and found that mindfulness can be applied beyond individual self-care practices.

Results indicated that self-care interventions were incorporated into the social work curriculum to teach effective self-care strategies (Grise-Owens et al., 2018; Lewis & King, 2019). Grise-Owens et al. (2018) focused on a self-care course integrated into the master level of social work curriculum. Components of this course introduced self-care, facilitated implementation through a self-care plan with ongoing updates and faculty feedback, and supported students with self-care resources and strategies. Almost all students (96%) indicated the assignments helped them learn skills for ongoing self-care, and most (76%) thought they would engage in self-care in the future.

Lewis and King (2019) embedded their curriculum into the undergraduate field practicum course, consisting of assessments, readings, direct instruction, and hands-on activities. During these activities, students had to self-assess their current level of functioning and develop a personalized self-care plan. Two studies (Lewis & King, 2019; Shannon et al., 2014) noted that life changes were the catalyst for implementing self-care. Barriers to self-care may include limited time, support, motivation, and guidance, along with personal and professional stressors.

Three studies had an intervention focusing on journaling (Kwong, 2016; Moore et al., 2011; Shannon et al., 2014). Kwong (2016) incorporated journaling as a form of self-care practice within a healthcare elective course for graduate social work students. Assignments focused on increasing self-awareness and therapeutic competence, becoming emotionally present and accepting limits, and assessing traumatic stress and self-care. Journaling each month provided students with a platform to process their thoughts, emotions, and struggles through difficult topics. Journaling tended to be associated with an increase in self-awareness and stress management.

Moore et al. (2011) incorporated the journaling exercises within the Foundation Practice course. Biweekly, students would maintain a self-care journal to address (a) the activities they undertook and why, (b) any specific issues the activity was meant to address, and (c) how the activity contributed to their spiritual, mental, emotional, social, and physical well-being. Journaling assisted students in learning about and how to implement self-care techniques, and stress reduction emerged as an outcome regardless of the self-care area.

Shannon et al. (2014) looked at research-supported practices for mediating the stress of trauma education, including journaling and MBSR. Students met weekly for 2 h over 15 weeks and completed journal entries every 3 weeks. Journal assignments included students’ feelings and thoughts regarding the readings, their behavioral responses (i.e., positive and negative) to the material, and their self-care strategies and thoughts on whether self-care strategies were effective. After the course, students could identify and develop self-care practices. In addition, the use of structured journaling facilitated the development of reflective practice competencies.

Curry and Epley (2022) focused on reflection with supervision—individually and in small groups. Individual reflection was about once a week for an hour and focused on building reflective skills. Small group reflection was once a week for about 2.5 h and focused on helping students develop reflective practice capacities, primarily self-reflection, and shared experiences. The results of the study were an increased level of awareness of (a) self, (b) self in relation to others, (c) multiple perspectives, (d) culture, and (e) context, systems, and policies. In addition, students learned that being in relationships was important to overall well-being. Regarding self-care, there was improved emotional health and better sustainability in the field.

Lauridsen and Munkejord (2022) studied a circle workshop over 6 days and included exercises, role-playing, self-care practices, and reflection. The goals of circle workshops were to strengthen participants’ skills in resolving their own conflicts, provide participants with tools to understand and support others in conflict, and understand how to use restorative circles with colleagues and clients for overall well-being. A talking piece was present to provide all participants with a safe space to speak and to listen to one another. Results included increased self-awareness during and after the circle process and increased ability in interpersonal communication, which resulted in higher stress tolerance, increased patience, and increased tolerance for discomfort.

Micsky and John-Danzell (2021) looked at the photovoice method, which is a participatory action research method using photography and journaling/short narratives to explore self-care and wellness and minimize burnout, compassion fatigue, and secondary traumatic stress. After instruction and readings, students were required to photograph their self-care experiences and then provide descriptions of their photos, answering the following questions: what do you see here, what is really happening, and how does this relate to my self-care plan? Students were also required to engage in discussion with their classmates regarding their photographs and description entries. From these assignments, common themes around self-care practices emerged, including physical exercise, family, friends, nature, creativity, and pets and animals. Feedback from students included being inspired to try things they may not have tried before in the realm of self-care practices and having a better understanding of prioritizing self-care.

Although comparison data were not collected, eight articles found an increase in personal growth or overall well-being after engaging in a preintervention (Curry & Epley, 2022; Kwong, 2016; Lauridsen & Munkejord, 2022; Lewis & King, 2019; McCusker, 2022; Micsky & John-Danzell, 2021; Shannon et al., 2014). Three articles noted a decrease in stress after intervention (Gockel & Deng, 2016; Kwong, 2016; Moore et al., 2011), and five articles highlighted the importance of self-care and its ability to overflow and enhance professional practice (Curry & Epley, 2022; Grise-Owens et al., 2018; Lewis & King, 2019; McCusker, 2022; Micsky & John-Danzell, 2021).

Discussion and Applications to Practice

Results from this systematic review indicate relatively few examinations of self-care interventions within the last decade. Among the 22 articles identified, 17 were based in the United States, and five were internationally based. Four authors were cited in multiple articles, and most interventions were mindfulness-based. Studies focused on samples of students (n = 16), practitioners (n = 4), and a mix of both students and practitioners (n = 2) and largely used mixed-methods research methods. Because the review focused on the type of intervention (i.e., pre- and posttest interventions and preinterventions), the summary of results is organized in the same manner.

Ten of the 12 identified studies used mindfulness or MBSR as its intervention, with indications of postintervention improvements in targeted outcomes, such as mindfulness, distress management, and clinical self-efficacy (see Table 1). MBSR studies have been implemented across the social work field encompassing social work students and practitioners (Gockel et al., 2013, 2019; Greene et al., 2019; Kinman et al., 2020; Lee & Himmelheber, 2016; Maddock & McCusker, 2022; Maddock et al., 2022; McGarrigle & Walsh, 2011). Using mindfulness could create moments of increased awareness, self-connection, and practicing remaining present in the moment (Gockel et al., 2013). Of the studies that collected pre- and posttest data for self-care interventions, results indicated that engagement in self-care led to an increase in mindfulness, self-compassion, reflection, and in levels of emotional self-efficacy. Although mindfulness is currently a popular intervention, it is important to note that other self-care practices studied (i.e., Quality of Life, The A-to-Z Self-Care Handbook, reflective practices, self-care workshops, and a holistic engagement practice) have also been shown to be effective. Furthermore, all but one intervention was integrated into a course, providing structure and guidance around self-care practices.

Social work students often represent vulnerable populations who experience high stress and burnout levels. Preparing students at the beginning of their careers could increase their self-care toolbox before they enter the professional realm. Mindfulness-based trainings were used across student populations (Gockel et al., 2013; Gockel & Deng, 2016; Maddock & McCusker, 2022; Maddock et al., 2022; McCusker, 2022). Incorporating mindfulness curriculum into students’ educational journeys was a trend discovered in the literature review. Two mixed-methods studies focused on evaluating mindfulness students during their program year (Gockel et al., 2013; Maddock & McCusker, 2022). Results mirrored prior research indicating mindfulness tended to improve students’ ability to integrate practices that include increased awareness, self-reflection, caring for oneself, and relaxation strategies while decreasing intrusive, ruminating thoughts (Gockel et al., 2013).

Social work students engaged in mindfulness-based assignments focused on increasing reflexivity and the development of regulation skills (Greene et al., 2019). One such tool for reflexivity that was supported by results is the use of journaling in self-care. Journaling is presented as a reoccurring theme and strategy used as a self-care component and tool to increase health and well-being (Kwong, 2016; Moore et al., 2011; Shannon et al., 2014). Self-care journaling is a unique, creative technique that allows the space for reflection, processing and assessing one’s emotions, and increasing awareness of self (Kwong, 2016). Stress can be managed through journaling and creative writing as it engages emotions and thoughts while allowing space for healing and growth (Moore et al., 2011). Creativity is an innovative, integrative option for self-care strategies that social work educational programs have incorporated into the educational process.

Preintervention studies were varied in methodology, including reflective practices, mindfulness, circle workshops, photovoice method, and multiple self-care curriculums. The results were promising, with reports of an increase in self-awareness, the ability to recognize and observe thoughts, feelings, and experiences, and a strive for personal well-being. All results indicated the interventions were essential in learning and implementing self-care techniques and skills for ongoing care, both personally and professionally. Although preinterventions are promising within the field of social work, results were mixed.

The scope of this article is limited to social workers, yet its tenets may translate to other helping professions. Future research can compare across and within helping professions. Moreover, research is preliminary, with a lack of comparison, small sample sizes, and an absence of structural, institutional, and multilevel interventions or outcomes. This article was limited to published, peer-reviewed journal articles. Other information sources outside this scope contain important information, including theses, books, policy briefs, and news articles. Much research on the interrelationships between related factors (e.g., compassion fatigue and burnout) may be found but was not included in this review as its scope was limited to articles with self-care as an explicit focus and outcome. Because of the nascent state of the literature, this review placed primacy on the state of self-care intervention research in social work over methodological rigor. Future research can examine more substantiated findings as the field of self-care intervention research develops.

Consistent with past research on self-care interventions (Griffiths et al., 2019), a majority (83%) of the limited research on self-care interventions with pre- and posttest data focused on mindfulness. Doran (2018) described the billion-dollar “McMindfulness” neoliberal industry, which places personal responsibility for self-care on individuals. This industry of self-care can promote hyper-consumerism, surveillance, and unsustainable expectations for productivity in underresourced institutional settings (Doran, 2018). Mindfulness may serve to assist with self-regulation and stress management, but social workers need skills to challenge the structures that cause distress. Mindfulness interventions may explicitly incorporate the use of mindfulness to address unsustainable structural inequities to ensure systemic long-term change.

Framing self-care as a personal responsibility rather than examining and addressing structural and institutional determinants perpetuates unsustainable individual responses to self-care (Barks et al., 2023); they fail to address where underlying mechanisms drive secondary trauma and burnout (Cuartero & Campos-Vidal, 2019). Focalized approaches to individual self-care practices ignore attention to the context and perpetuate privilege to those who can afford the time, space, and resources to access self-care practices while sustaining the other parts of daily life (Barks et al., 2023). The framing of self-care as an individual and personal responsibility (Pyles, 2020) neglects the structural conditions that drive compassion fatigue, job turnover, and burnout (Apgar & Parada, 2022; Bressi & Vaden, 2017; Griffiths et al., 2019).

Future research and programs are needed that incorporate multilevel interventions that incorporate macro-, meso-, and microlevel change; interventions pose a danger of replicating unsustainable systems that create burnout and undermine social work practice. Moreover, given identified interventions all focused solely on individually modifiable factors, yet structural factors and socioeconomic privilege have been found to be predominant predictors of whether social work students, educators, and practitioners engaged in self-care practices (Barks et al., 2023)—systemic and institutional approaches to self-care in social work are needed.

Many studies and articles focused on the development of integrative programming used to increase self-care in the social work field. Miller (2020) developed a self-care curriculum based on conceptualized, planned, implemented, evaluated, and sustained principles to increase self-care practices in social work students. Development of this program expands the integrative, organizational program that places responsibility on the macrostructures. Organizational and institutional structures that include self-care as an essential part of their responsibility remove barriers while increasing accessibility to maintain healthy social work practitioners and students. It is imperative that social work leaders implement a self-care curriculum or programming that will equip social work professionals and students with a foundation of healthy self-care practices (Miller, 2020). Preparing students for their professional careers could increase their ability to maintain them healthily. Results from this review indicated that personal life changes and self-care strategies went hand-in-hand, and these self-care strategies can help maintain balance and carry over to the professional world. Students indicated the value of self-care training and felt better equipped to transfer these skills after graduation (Shannon et al., 2014).

Outside of these educational and professional entities, self-care continues to be the individual’s responsibility, which does not seem sustainable long term. Prioritizing processes and supports for social work students and practitioners to engage in self-care practices can create impactful changes, thus encouraging and maintaining overall well-being. For long-lasting effects, individuals and organizations need to focus on implementing interventions (Awa et al., 2010; Pyles, 2020). Self-care practices must be an obligation for social work students and practitioners to protect themselves from all the outcomes that arise from a lack of self-care and to improve themselves as practitioners, helping their clients develop effective and long-lasting care plans. Intervention programs should also include refresher courses to have longer-lasting effects (Moore et al., 2011). Refresher courses and education around self-care must be taught at all levels of social work, including frontline workers and management. As advocates in the helping field, social workers need to take a stand on having self-care resources available to them and implemented within agencies and organizations.

Napoli and Bonifas (2011) developed a quality-of-life program to explore self-care strategies and increase healthy stress responses. Mindfulness skills were weaved into the program to increase awareness and connection to living a healthy life. Creating classrooms that support mindfulness and self-care can increase the ability of students to enhance their health and well-being throughout the duration of the educational journey (Napoli & Bonifas, 2011).

Self-care programming and curriculum in social work education are crucial to better prepare future social work practitioners to manage work–life balance and stressors in the field. Immediate and incremental institutional adjustments can be made to promote wellness and reduce stress among social work students, faculty, and staff, such as improving collegiality, making time and allowance for self-care, improving the work and social environment, and increasing support and resources (Barks et al., 2023). Many social work programs incorporate self-care across many domains to support staff and student health and well-being. Social work education self-care curriculum programming expands from undergraduate to master’s-level programs (Grise-Owens et al., 2018; Lewis & King, 2019). Increasing accessibility to self-care programming and curriculum across all levels of social work education is an important component of sustainability and progress of health and well-being. Multilevel interventions are recommended for alignment and ability to meet challenges that arise across systemic, institutional, and relational levels.