Social Work Practices in AsianCountries in COVID-19-Community Resilience andMental Health Well-Being"Post-Traumatic Growth
Theory and Methods"
Takashi Fujioka Ph.D
Professor
Japan College of Social Work, JAPANCurrent status of COVID-19 related
crisis in Japan(at January 24 2021)
Japan• Domestically infected people (9 pm on January 24) 3990
people a day• Dead： 56 people a day• During hospitalization / medical treatment 64662 (-618
people from the previous day)in which, 1007 seriously ill (-2 from the previous day)
• Number of confirmed infections in Japan (cumulative total)
365,878• Total number of discharged persons: 291201 (+5020 fromthe previous day)
• Number of deaths (cumulative) 5120
(Source: Asahi Shimbun, January 25, 2021 morning edition)

Severe situation in Japan(1st wave, 2nd wave, 3rd wave)

Current situation and issues in Japan(elderly area)• High risk of aggravation of infection• Anxiety about the cluster• Consideration for family interviews
Mask, face guard, protection as an infection
countermeasure
Limited time for clothes (15 minutes, etc.), limited method(utilization of remote, etc.)
Limitation on the number of people who can meet
Limited interaction with family• Support for the elderly at home
Risk of aggravation of the elderly, anxiety about infection offamily members living together (consideration of refraining
from going out, etc.)

Current situation and issues in Japan (disability area)
・ Prolonged stay at home when a state of emergency was
declared, and continued refraining from going out thereafter・Behavioral changes
・Rebuilding family relationships
・Change of work by family to remote
・Changes in family conditions such as during the day
Positive side
Strengthening family relationships
Negative side
Deterioration of relationships
Reconstruction of division of roles
・ Dealing with mask sensitivity, routine daily changes,
anxiety caused by not wearing masks at home, on the train,etc., family stress, increased resistance to going out

Current situation and issues in Japan(children and family social work/welfare)・Children or/and Family Welfare Facility
・Support at home due to school closure when an emergency
is declared. Increased support, sharing of time and spacewith children.
・Staff stress
The work-life balance of staff is lost・Concerns about child abuse in Facilities and foster homes
・Cancellation of regular annual events at the facility
・Development of new events in the facility
・Support for children in the area such as children's cafeterias
and learning support, difficulty in catching needs,
development of regional cooperation

Social isolation of children after social careand in-care for children• Regular aftercare does not reach children and young
people.
• Young people cannot go to the facility to avoid the risk ofinfection.
• Young people are suddenly in poverty (due to the financial
impact of COVID-19 ), including dismissals from
employment.
• Young people face again the fact that they lived ininstitutions and that their parents could not become
caregivers. Difficulty in re-employment.
• An attempt to reconstruct a social network by online
remote. Social solidarity through SNS. Development of
support methods that use both remote and face-to-face.
Trauma for both professionals and young people, support
for building relationships ... New lifestyle post-COVID-19

Current situation and issues in Japan (medical /psychiatric social work/welfare area)
・Increase in suicide (exceeding the previous year for the first time in 11 years
since 2009 at the time of the Lehman shock. 2020 preliminary figures) 20919(including 6978 women, 885 14.5% increase from the previous year: 440
elementary, junior high and high school students, 18.3% increase from theprevious year. (Economic impact of Corona's disaster, changes in living
environment, school closure, refraining from going out, etc.)
Increased in all generations except 50s and 60s. Especially under 19 years old
13.8% increase, 16.8% increase in 20s. 307 high school students. Female employee
29.5% increase, increase in sales / service industry and medical staff.
(From the 2020 preliminary figures of the Ministry of Health, Labor and Welfare).

・Increase in social isolation
・Financial distress and anxiety
・Increase in store closures, company bankruptcies, etc.
・Economic impact due to extension of self-restraint
・Discrimination and prejudice against medical staff. Care fortrauma of medical staff.
・Loss of patient, Care for the family of the deceased patient, etc.

Issues common to various institutional
clinical practice・Restrictions on direct support
・Restrictions on support methods such as touching thebody・Can't go for a walk・Can't go on a trip as an event in the park・Ingenuity of events in the facility
・Avoid the Three Cs（Crowded places , Close-contact
settings, Confined and enclosed spaces）(social distance and distance for support)
・Nursery homes, facilities for children with disabilities,
etc. that cannot provide dietary guidance as expected

"Connection" and "social solidarity" as keywords• "IBASHO (Japanese)" (whereabouts) (People lose their placebecause they lose their connection with people) In IBASHO, people
can feel "place where one can be oneself" with people.
• Among the risks related to corona, people are keenly aware of"social isolation" due to "living alone".
• Refraining from going out, securing social distance, etc. promoted
isolation.
• Reliance (when a person can experience the "feeling of being alive").
• Faced with the lack of communication on a daily basis.
• Who is the most important person for me? Searching for aconnection.
• Connection (importance of feeling "not alone")• The main points of social work. Network construction. Circle ofsupport.
• Community resilience area, local community,• Expansion of social networks (social media, SNS, email, Zoom,
Google meet, etc.) From a slight connection.

Corona's impact on social work/welfare education
・Restrictions on practical training and exercises (conflict withsecuring learning through practice)
Online, remote lessons
Hybrid type class
Practical training restrictions
Understanding the importance of practical training byfacilities / institutions and infection control.
・ Coordination with facilities / institutions in advance(coordination of infection control)・Necessity of health check before, during, and after training
・Necessity of field training in the area of social work/welfare
・Importance of exercises and experiential learning in social
work/welfare education

Mental Health Well-being"Growth After Trauma “ Theory and Method
The main concept of “Support for Human Service
Professionals (HSPs)”.
• “Support for HSPs” means “Support for Users”, and“ Support for Users” means “Support for HSPs” .
Sharing of well-being, well-being by "co-existence".
• Compassion Fatigue• Secondary Traumatic Stress, Vicarious Trauma• Compassion Satisfaction• Burnout• Emotional Labor• Post-traumatic Growth (PTG)• Resilience
Fujioka (2020)

Support for Human Service Professionals –Various concepts
Burnout

Resilience

Emotional Lavoｒ
Compassion Fatigue
Compassion Satisfaction
Secondary Traumatic Stress
Vicarious Trauma
Post -traumatic GrowthNecessity of support for Human Service Professionals–”Support for HSPs” theory・Issues of secondary damage or victim to staff（Erosion to staff）
・“Secondary damage and victim” as a clinical trauma
task
・Inevitability of support for HSPs
・The trauma concept itself is premised on the spreadof ripples: primary (clients, users), secondary (parentsof clients or users, staff, foster parents, etc.), tertiary(supporters / supporters‘ families, etc.). . (Figley, 1995)
・Compassion Fatigue (trauma dominance, stressdominance, depression dominance) （Fujioka,2020）

Human Service Professional 's dilemma
It is said that relationships are important inassistive technology, and compassion/empathy isimportant. A deep and hurt experience is told toa HSP on the premise of a peculiar relationship oftrust (rapport) for the support / assistance of theuser and the HSP, with the guarantee of
acceptance and empathy. That is, the more HSPs
exercise their supportive expertise in establishingempathy and relationships of trust, the more
likely they are to encounter such situations(prone to Secondary Traumatic Stress andCompassion Fatigue). There is a dilemma here
(Fujioka, 2006).
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Compassion Fatigue, Compassion Satisfaction, Burnout
measures (items)
・Utilization of self-checklist
・Consideration of the HSP's family for tertiary traumatic stress・Support strategy for ”Support for HSPs”
・Separation of work and personal life (intentional division)・Orientation to a healthy life, recovery from the body ... Building
an axis of the body, awareness of tension, awareness of body pain
and modulation
・"Sense of connection" with people
・The harder it is to support, the more you talk about your hardships tothose around you and those close to you. Dealing with silencing
reactions.
・A monitor of the HSP's sense of integration (unity). Your own job, asatisfying job.
・ Support each other in the workplace. Respect and Civility(courtesy)
for each other.
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Attempt to support HSPs online
Online stress check and self-check of countermeasures
https://www.hh-scare.com/

Self-care complete typeCompassion Fatigue scale composed of excerpts from self-support
items
Each person gave scores, read the explanation about those scores,
Self-check
Each person wrote a positive message to himself/herself and sent it.

Feedback intervention type
After self-checking the same content as above, support individually.
Continue self-checks and ongoing interviews. Group interview,
individual interview, etc. Method: The stress care team talk with
HSPs(Human Service Professionals).

Self-care complete type
• Explanation: Click this checklist, refer to the stress coping
leaflet and checklist manual, and look back on Human
Service so far to improve your self-care ability. In Checklist
A, where you send us your email address, you can enter
your email address and we will reply to your email address
as soon as the answer is complete. In addition, we will
provide information such as feeding back the overall
statistical results after data collection. This checklist is
optional and you can stop in the middle.
• Worker's Self-Care Checklist A (Anonymous; Enter Email
Address; Send Answer to Email Address)
Workers' Self Care Checklist B (Anonymous)
Self-care checklist manualStress coping leaflet
Relaxing method for sleep (Youtube)

Feedback intervention type
Explanation: A medical institution, welfare facility,or school sets up “a stress care team“ for staff anduses the self-care checklist A (Google survey) ofworkers to interview and advise applicants andhigh-stress staff. It does not mean that the memberof this “worker's self-care study group” would
follow the attended staffs. Staff responses aremanaged by “the stress care team”. We would
email you how to manage your answers with justthe stress care team. This is a method of
distributing a questionnaire (ex. medical institution
sample version) within the institution concernedand having them answer from their smartphones.

Worker's Self-Care Checklist(Stress Questionnaires)

You will be asked to check 5 items of psychosomatic
reactions that can occur in extraordinary situations forworkers. Check out the numbers that apply frankly to
how often you've experienced in the past week. In
addition, "the persons whom you support" refers to all
the people you have been involved with, and is not
limited to those who are undoubtedly positive about the
new corona (Figley & Fujioka, 2010).
1. Sometimes I'm overwhelmed by the time I spend withthe most difficult people I've helped. 2. Trivial things can
explode your anger or make you irritated. 3. There is asense of hopelessness associated with working with thepeople I support. 4. I feel tied to my current job as asupporter. 5. I feel estranged from others.

An important experience for self-care of workers (HSPs)
The following 12 items are important for reducing stress response in extraordinary
situations. How often have you experienced the following in the past week? 12 items
from 21 items in Fujioka (2008).
1. Do you feel that your family and friends are accepting the hardships of your work?
2. Do you feel that people at work are accepting the hardships of your work?
3. Do you feel that being a supporter makes your family tired or annoyed (even if you
are away)?
4. Have you ever consciously made a distinction between work and your private time?
5. Do you ever get frustrated with your family and friends?
6. Do you share the satisfaction you feel at work with people at work?
7. Do you value humor and laughter at work?
8. Do you value your basic lifestyle, such as sleeping, eating, and resting?
9. Do you relax your body or use relaxation methods when you feel tired?
10. Do you use words to convey the feeling of " hardships " to people nearby when
you feel hard?
11. Do you value the feeling of being connected to people (talking, spending time
together, etc.)?
12. Do you tell people around you what you think the limit that you cannot do?

Online support for HSPs
(Currently being analyzed)
It is suggested that the improvement of self-support items may
suppress the increase in stress.
Discrimination and prejudice against medical professionals are issues
in Japan
It is suggested that discrimination and prejudice may be greatly related
to the stress of medical staff (currently being analyzed).
Necessity of “ the Model of Support for HSPs in Corona (COVID-19)
related crisis”
Post-traumatic growth theory and method of “Support for HSPs”
contributes to maintaining and enhancing HSP resilience.
Combined online and face-to-faceImportance of “Support for HSPs”• Emotional Availability of HSPs, Emotional Availability ofusers or clients.
• Sharing time and space (physical and psychological). Coexistence. Creating a "support vessel" for the HSP by cosupporters (expanded concept from "Attachment vessel" by
Fujioka 2008)• 1, Predictability 2, Sensitivity 3, Availability 4, Proactivity
5, Existence (Fujioka 2020)• "Support Vessel": HSP, HSP's family, HSP's workplace,
support place (facility / institution), school, community.
• What is required now ... Rediscovery and reconstruction of"Support Vessel“ or "Support Network“ for HSPs.
• Necessity of “Support for HSPs Coordinator” and “Supportfor HSPs Supervisor”

Key points of support("support vessel" for HSPs )(1) Predictability (The behavior of HSPs can be predicted fromthe user) How does the user see them? Ability to " bePredicted"(2) Sensitivity (HSPs can sense various behaviors of the user) ...
Ability to have "Gentle Eyes" to the user. Group /Individual(3) Availability (awareness and communication that HSPs areavailable and useful to users) ... Ability to " be Available "(4) Proactivity (Catching the needs of users and actively
engaging in proactive activities) ... Ability to "believe"(5) Existence (the existence of the HSP can be confirmed forthe user) ・ ・ Ability to “exist”
Through the above, the importance of the HSP being"integrated as a supporter" ... the importance of the role ofthe HSP(Human Service Professional)
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“Support for HSPs” Coordinator• A staff member within a facility / institution who has thetask of coordinating support for HSPs. The person haslearned or trained knowledge about support for HSPs and isalso proficient in “support for HSPs” techniques. (Fujioka,T.
2020 ).
• He/she should have at least one person in each department(ideally one coordinator for every five staff members).
Social workers (SW), psychiatric social workers (PSW),
medical social workers (MSW), psychological professions,etc. can play that role (doctors and nurses are in a position
to receive support).
• It was pointed out that "rebuilding work-life balance,
rebuilding relationships in the workplace, rebuilding
relationships with families, rebuilding relationships with thecommunity" is important support by the “Support for HSPs”
coordinator. (Fujioka 2020).

“Support for HSPs” Supervisor
A person who advises HSPs and “Support for HSPs”
coordinators on support for HSPs. The person has awealth of insight and knowledge on support for
HSPs, and also a “support for HSPs” technique.
A person can advise Support for HSPs Coordinator.
In carrying out the duties, it is important to be able
to cooperate well with the coordinator in the facility/ institution and give advice so that the facility /institution can act as a team. "(Fujioka,T. 2020).
Professionals (SW, PSW, MSW, psychologicalprofessionals, psychiatrists, etc.) who are
outside/inside the facility / institution and haveknowledge and experience in supporting HSPs canbe “Support for HSPs” Supervisors.

The task in New lifestyle post-COVID-19
・Issues that originally existed in the field of social Work/Welfare areexposed or become more serious in this Corona (COVID-19) related crisis.
The need to reconstruct relationships with oneself, family, workplaces,
schools / facilities, and communities under the circumstances of thisCorona (COVID-19).
・Necessity of reexamination of communicationFace-to-faceRemote online
Possibility of utilizing SNS, LINE, etc.
What do you care about? ・ ・ "Growth after Trauma"
・An online tool that can be used as a catalyst for support and continuity
Reviewing the importance of face-to-face support. What we can do. What
we cannot.
・The importance of support for exhausted HSPs(Human Service
Professionals), Highlighted by this Corona (COVID-19) related crisis.

Practice in New lifestyle• What we can or can‘t do by face-to-face ... Possibility of “supportfor HSPs”・・・・HSP(Human Service Professional)
People-to-people contact and dialogue
Not limited to face-to-face
Recapture of time
Importance of contact that can be made even in a short time
• Utilization of various tools in relationship building and relationshiprepair.
• Workplace / organizational support, community support from theperspective of support for HSPs (“rebuilding work-life balance,
rebuilding human relationships in the workplace, rebuilding
relationships with family members, rebuilding relationships withthe community”).

• Building and Restructuring of “Social Solidarity”
user, family , community, HSP, Supporter for HSP・・・・

Citations• Asahi Shimbun. Suicide increased for the first time in 11 years (Saturday,
January 23, 2021 morning edition)• Fujioka,T. 2020 Supporter Support and Childcare Theory -Reconstruction of
supporting to Children and Family- Minerva Shobo (in Japanese)• JIJI.COM “Third wave” convergence not foreseen, total number of infected
people exceeds 310,000-one year since the first confirmation in Japan,
Corona (COVID-19) related crisis (January 16, 2021, 07:13
https://www.jiji.com/jc/article?k=2021011500766&g=soc(2021.1.25 search)
・ NHK. World Infection Status(as of 18:00 on January 24)
https://www3.nhk.or.jp/news/special/coronavirus/world-data/(2021.1.25 search)• Self-care for workers. Support site for supporters of COVID-19
https://www.hh-scare.com/