Transcript File - 2014 Trauma Informed Care Conference

Secondary Traumatic
Stress in the Workplace
Dr. Kim Shackelford, LCSW
Deputy Administrator
Department of Human Services
Division of Family and Children’s Services
Objectives:
Participants will acquire knowledge and skills to be able to:
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Understand the dynamics of Post-traumatic Stress, Burnout, and
Secondary Traumatic Stress
Determine the relationship of traumatic stress to professionals
who work with trauma victims
Assess personal and professional self-care
Manage direct and secondary traumatic stress
Determine and identify appropriate responses to supervisees and
co-workers who are experiencing traumatic stress
Plan for personal and professional care/social support and
management of direct and secondary traumatic stress
Examine organizational response needs and provisions for helping
staff manage Direct and Secondary Trauma responses
What is the responsibility of
professionals to prepare
themselves and others for
working with victims of trauma?
Before….
Security
 Safety
 Equilibrium
 Homeostasis
 Normal Stress
 Overall – the
world/life is
predictable, ok, fair
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After…
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Security is threatened
Safe feelings are gone
Disequilibrium
Abnormal stressors
The world/life is not
fair, predictable
Nothing will ever be
the same
Types of Posttraumatic Stress
 Primary
 Secondary
 Not
to be confused with Burnout
 Not to be confused with
Countertransference
Previously held beliefs…
about a fair and just world are no
longer valid.
Literature & Theory
 McCann,
I.L., Sakheim, D.K., &
Abrahamson, D.J. (1988). Trauma
and Victimization: A Model of
Pyschological Adaptation.
 McCann, I.L. & Pearlman, L.A.
(1990). Vicarious Traumatization: A
Framework for Understanding the
Psychological Effects of Working with
Victims.
Literature and Theory
 Figley,
C.R. (1995). Compassion
Fatigue: Coping with Secondary
Traumatic Stress Disorder in those
who Treat the Traumatized
 Figley, C.R. (2002). Treating
Compassion Fatigue.
 Pryce, J., Shackelford, K., Pryce, D.
(2007). Secondary Traumatic Stress
and the Child Welfare Professional.
Several studies called for the inclusion of
information regarding the effects of indirect
trauma on persons working with victims of
trauma in social work education programs.
(Bell, Kulkarni, & Dalton, 2003; Black, Jeffreys, &
Hartley, 1993; Cunningham, 2003, 2004; Dalton,
2001; Dane, 2000; Fournier, 2002; Maidment,
2003; McCammon (1999); Morrison, 1990;
Nelson-Gardell & Harris, 2003; Pryce,
Shackelford, & Pryce, in press)
 “Those
who work with the suffering
suffer themselves because of the
work.”
 C.R.
Figley, 2002
Treating Compassion Fatigue
Indirect Trauma
Why indirect trauma?
Trauma is part of our world and social workers are
often there to help pick up the pieces – indirect
trauma is what happens to the social worker
when others face traumatic situations and social
workers attempt to help them.
Social Work often involves restoration of lives of
persons who have been traumatized.
(Bride, in press; Cunningham, 2003, Pryce, J.,
Shackelford, K., Pryce, D. 2007)
When working with traumatized individuals,
professionals can be affected…
emotionally
 physically
 cognitively
 socially
 interpersonally
 spiritually
(Bride, 2004; Bride, in press; McCann &
Pearlman, 1990; Morrison, 1990;
Pearlman & Saakvitne, 1995; Pryce,
Shackelford, & Pryce, 2007; Valent, 1995)
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Effects on the Professional
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changes in frame of reference
changes in self capacity
changes in ego resources
psychological needs & thought processes,
safety, esteem, trust, control, intimacy,
independence
memory and perception change
(Saakvitne & Pearlman, 1996)
Effects on the clients
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A soul weary social worker is not able to
be helpful to the client (Stamm, 1999)
Compassion fatigue results in
professionals leaving the field (Figley,
1995; Pryce, Shackelford, & Pryce, 2007)
Impaired professionals should not
continue to practice – duty to clients
(NASW Code of Ethics, 1999)
Saakvitne & Pearlman (1996)
“self-care is an ethical imperative. We
have an obligation to our clients – as
well as to ourselves, our colleagues,
and our loved ones – not to be
damaged by the work we do.”
Information has been found to be the
key to mitigating the effects of
indirect trauma.
(Bell, Kulkarni, & Dalton, 2003)
Preparation of Undergraduate Social Work Students to
Cope with the Effects of Indirect Trauma
Shackelford (2006)
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Cross-sectional survey of recently graduated BSW social
workers in the United States (random selection)
Recently graduated BSW students – NASW members in
transition (N=192) (30% response rate)
From 39 states and the District of Columbia
Recently graduated BSW’s recognized burnout and
posttraumatic stress disorder more often than secondary
traumatic stress, compassion fatigue and vicarious
traumatization
Recently graduated BSW social workers do not have
adequate knowledge of indirect trauma.
Cross Tabulation of History of
Trauma as a Child and as an Adult
Trauma as Adult – No
Trauma as Adult - Yes
Trauma as a Child – No
Trauma as a Child – Yes
34
23
26
107
Total
57
133
Out of 190 respondents who answered these questions, 130 reported
childhood trauma and 26 more reported adult trauma.
Study of Child Welfare Workers
Pryce, Shackelford, Pryce (2007)
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All five states endorsed the following:
Avoided thoughts and feelings
Experienced traumatic events in adult life
Feel trapped in my work
Feel hopelessness working with clients
Have been in danger working with clients
Study of Child Welfare Workers
Pryce, Shackelford, Pryce (2007)
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4 states endorsed the following:
Feel estranged from others
Have difficulty falling or staying asleep
Startle easily
Experienced traumatic events in childhood
Am preoccupied with more than one client
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10 of the 17 posttraumatic stress
symptoms were endorsed
Building Worker Resiliency
Describe the work realistically
 Educate at the beginning about STS
 Address personal traumatic stress and
unresolved trauma
 Clarify the agencies responsibilities to the
worker regarding STS as an occupational
hazard
 Clarify worker’s responsibility for self care
 Give extra care to new and younger
workers
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Management of STS increases the
ability to keep hope alive for
professionals and clients!