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square bulletCreating Conditions for Hope

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From , MSW, LICSW, Professor of Practice, Trauma Informed Oregon

Last month, I attended the 2026 International Association for Social Work with Groups International Symposium. During a presentation titled When Safe Spaces Disappear: Grief, Resilience, and Hope, two LGBTQ+ practitioners shared findings from routine client satisfaction surveys that revealed an unexpected outcome. Though their clients consistently reported strong therapeutic relationships, high engagement in treatment, and motivation to achieve their goals, they continued to struggle with hope because spaces that accepted their identities were shrinking. I wondered whether their providers were struggling with the same thing, too.

We are navigating a period of chronic stress activation driven by societal-level harm: political uncertainty; funding cuts across social services, education, and research; growing economic insecurity; escalating climate-related disasters; and ongoing global conflict. Medicaid reductions are shrinking programs, causing layoffs, and increasing caseloads. Immigrant communities are being blatantly targeted and attacked. Efforts related to diversity, equity, and inclusion are being challenged or dismantled. For many social service practitioners, these realities create a relentless cycle of stress activation without sustainable opportunities for recovery. Our nervous systems are being asked to adapt to chronic uncertainty and fear while continuing to care for others experiencing the same threats. What we are experiencing is unprecedented and stems from a long legacy of colonization and oppression woven into our systems and practices.

Many organizations seek to address these challenges by implementing workforce wellness policies. These may include affinity-based employee resource groups, open-door leadership policies, time off, and relationship-building opportunities. These are vital, useful, and important. And yet, even with these supports in place, staff can still experience high levels of burnout. This can cause frustration for leaders who may feel they are doing everything right but still feel that everything is wrong. In many ways, this is true. When larger societal stressors are at play, there is only so much leadership can do.

At TIO, we work with organizations implementing trauma informed care that ask us how they can create thriving workplaces while being steeped in toxic stress and adversity. I don’t have a full answer, but I do know it is an ongoing, collective process. Creating a workplace where people can thrive requires collective ownership of workplace culture. Organizational leaders cannot carry this responsibility alone, and neither can frontline staff. Every person within an organization contributes to the environment they work in.

Though the societal stressors many are experiencing can feel new, trauma informed research offers practices for responding to toxic stress. Toxic stress is the excessive, frequent, or prolonged activation of the body’s stress response system. It occurs when an individual experiences severe adversity without the protective buffering of supportive relationships or coping mechanisms. The outcomes of toxic stress for providers can include burnout, compassion fatigue, vicarious traumatization, moral injury, and secondary traumatic stress.

The Intrapersonal Level: Me, Myself, and I

The effects of toxic stress build gradually through persistent emotional exhaustion and a growing sense of disconnection from ourselves and our work until we suddenly feel steeped in it. While we are not responsible for the conditions that activate our stress responses, we do have agency in how we respond to them. This begins with reflection and engagement.

When organizations I worked with in the past created opportunities for staff input, participation, and advocacy, engagement pulled me out of the fog of burnout. If there were opportunities to provide feedback, join committees, participate in employee resource groups, or advocate for meaningful changes, I found action, any action, a powerful antidote to helplessness.

Research consistently demonstrates that protective factors such as motivation, self-efficacy, humor, and optimism can buffer the effects of occupational stress. These are skills that can be strengthened through intentional practice and organizational support. Mindfulness, self-compassion, meaningful recovery time, and reconnecting with personal and professional purpose can all help with navigation of toxic stress.

At the same time, staff may want to engage in all of these opportunities but simply lack the energy or mental space to do so.

The Interpersonal Level: You and Me

Humans are wired for connection, particularly during times of stress and uncertainty. Social support remains one of the most consistently identified protective factors against the impacts of toxic stress. Trauma informed workplaces strive for honest conversations, mutual support, and shared accountability. Teams that thrive are those in which colleagues notice when someone is struggling, offer support without waiting to be asked, and create environments in which vulnerability has space to be received. This also means being accountable to one another through honest conflict resolution, prompt communication, regular responsibility sharing, and flexible but firm boundaries.

Peer support matters deeply, but it cannot carry the full weight of systemic challenges.

The Organizational Level: You and All Is Y’all

Organizations have the greatest responsibility, and often the greatest opportunity, to influence workforce well-being. A meta-analysis of physician burnout found that organization-directed interventions were associated with moderate reductions in burnout, while physician-directed interventions were associated with smaller reductions. Organization-directed interventions included process improvements such as EHR optimization, reduced documentation, team expansion, and the use of scribes to handle clerical work. In short, meaningful reductions in burnout are associated less with wellness offerings and more with improvements to workplace conditions. Workload, agency, staffing levels, administrative burden, and psychological safety have a greater impact on well-being than wellness programs alone.

This means organizations must look beyond workforce wellness incentives and examine how work is structured:

  • What processes create unnecessary burdens? (How many clicks does it take to write a note?)
  • Which requirements are essential, and which can be streamlined or eliminated? (Do clients need to write their name on every form?)
  • Do staff have meaningful input into decisions that affect their work? (Do staff have a responsive pathway to offer suggestions?)
  • Are wellness activities integrated into protected work time? (Is workforce wellness an additional expectation for overextended teams?)

Creating a trauma informed workplace requires leaders to listen carefully to feedback and translate that feedback into meaningful change.

Conclusion

The practitioners at the symposium inspired a question many readers may be holding: What do we do when we are doing everything we can, and hope still feels difficult to hold?

While organizational practices cannot eliminate the compounding effects of societal trauma, we can focus on what is within our sphere of influence. Individuals can engage in reflection and advocacy. Teams can strengthen connection and shared accountability. Organizations can listen to feedback, reduce unnecessary burdens, and address the structural conditions that contribute to burnout.

Wellness initiatives are most effective when they exist alongside meaningful changes to workload, autonomy, psychological safety, and workplace culture. We cannot offer wellness while maintaining the conditions that make well-being impossible. Perhaps the task is to create workplaces and communities where difficult realities can be named honestly, burdens can be shared, and hope has the conditions it needs to grow.

Resources Utilized for This Blog

The International Association for Social Work with Groups 2026 Symposium: https://www.iaswg.org/-2026-schedule

De Simone, S., Vargas, M., & Servillo, G. (2021). Organizational strategies to reduce physician burnout: A systematic review and meta-analysis. Aging Clinical and Experimental Research, 33(4), 883–894. 

Tamminga, S. J., Emal, L. M., Boschman, J. S., Levasseur, A., Thota, A., Ruotsalainen, J. H., Schelvis, R. M., Nieuwenhuijsen, K., & Molen, H. F. (2023). Individual‐level interventions for reducing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews, 2023(5), CD002892. https://doi.org/10.1002/14651858.CD002892.pub6

Meredith, L. S., Bouskill, K., Chang, J., Larkin, J., Motala, A., & Hempel, S. (2022). Predictors of burnout among US healthcare providers: A systematic review. BMJ Open, 12(8), e054243. https://doi.org/10.1136/bmjopen-2021-054243