Transcript Clinical Stories with Issues of DV: An Open Forum

Clinical Stories with Issues of
DV: An Open Forum
Talking about things that matter
with people doing the work
Gary Direnfeld, MSW, RSW
www.yoursocialworker.com
www.yoursocialworker.com
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Why Talk?
 Working in the area of domestic violence has
particular challenges and rewards
 The challenges can threaten the integrity of the
worker
 The rewards can provide a tremendous sense of
personal satisfaction
 Talking can help overcome the challenges and
improve the likelihood of reward.
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Challenges Include
Certain Risks
 Risk of attack
 Risk of burnout
 Risk of psychological stress reactions
www.yoursocialworker.com
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You can get hurt
Did You Know
 More than 1/2 of social workers in Massachusetts * have been
physically assaulted in a work related incident (assaults range
from pushing, hitting, and choking to life-threatening attacks)
 More than 3/4 have been verbally abused
 More than 1/3 have had a weapon brought into the workplace
 Over 3/4 have been frightened, even without physical or verbal
threat or assault
* Based upon a survey of 1,000 Massachusetts NASW members and review of literature.
www.yoursocialworker.com
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Violence Is Unacceptable
 Violence, threats and abuse to staff are
unacceptable.
 This includes sexual and racial
harassment, and threats to family and
property.
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Promoting Safety
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a statement of the organization's policy that clearly sets out a code of
practice that fits your job and where you work
clear assessments of the risk to you from the individuals, families and
groups you work with
clear procedures about what to do when you think there is a risk, what
to do after an incident, and what follow-up there will be
training that fits your job, including what responsibilities you have
towards colleagues and to service users
a working environment that maximizes your safety
support in dealing with your concerns about threats, abuse and violence
procedures for making sure precautions are working and can be
reviewed
easily available support after an incident that fits what you and others
who were involved need to recover from the experience.
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Burnout
 The term "burnout" has been applied
across helping professions and refers to
the cumulative psychological strain of
working with many different stressors. It
often manifests as a gradual wearing
down over time.
National Center for Post-Traumatic Stress Disorder
www.yoursocialworker.com
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Factors Contributing
To Burnout
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Professional isolation
Emotional drain from empathizing
Difficult client population
Long hours with few resources
Ambiguous success
Unreciprocated giving and attentiveness
Failure to live up to one's own expectations for effecting
positive change
National Center for Post-Traumatic Stress Disorder
www.yoursocialworker.com
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Symptoms Include
 Depression
 Cynicism
 Boredom
 Loss of compassion
 Discouragement
National Center for Post-Traumatic Stress Disorder
www.yoursocialworker.com
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Treatment and Prevention
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Proper diet, nutrition and rest
Physical activity
Social action
Good supervision
Realistic goals
Realistic workload
Variety in caseload
Collegial support
Taking holidays!
www.yoursocialworker.com
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Hearing Horrendous Stories
Can Hurt the Listener
 Secondary Traumatic Stress
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Stamm 1995
Sub-clinical or clinical signs of PTSD that mirror those experienced by trauma clients
 Compassion Stress/Fatigue
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Figley 1995
Sense of helplessness, confusion, isolation or secondary traumatic stress symptoms experienced
by the worker
 Vicarious Traumatization
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Pearlman and Saakvitne 1995
Permanent transformative, inevitable changes that result from work with trauma survivors
Cognitive schemata – e.g personal safety in the world or relationships
www.yoursocialworker.com
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Treatment and Prevention
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Same as for burnout and
Debriefing specific horrific cases
Counselling
Learning to set personal boundaries to keep from
acting beyond your role
 Stress management strategies such as yoga
 Limiting alcohol in favor of health promoting
activities
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Compassion Satisfaction
Figley also discusses the “upside” of
working with trauma clients:
 Sense of strength
 Self-knowledge
 Confidence
 Sense of meaning
 Spiritual connection
 Respect for human resiliency
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Self Care
It’s OK to have fun!
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…and more fun
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Clinical Stories with Issues of
DV: An Open Forum
Talk amongst your peers and agency staff,
discuss the challenges, arrive at mutually
acceptable solutions and HAVE FUN!
Gary Direnfeld, MSW, RSW
www.yoursocialworker.com
www.yoursocialworker.com
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