Transcript Compassion Fatigue

COMPASSION FATIGUE
AN OVERVIEW OF SECONDARY TRAUMATIC
STRESS DISORDER
PRESENTED BY:
SANDRA GORMON-BROWN, MSW, LICSW & LORI EASTEP, MSW, LICSW
OF GRASSROOTS THERAPY GROUP
WWW.GRASSROOTSTHERAPY.COM
WELCOME
 Activity: easel paper
 Trainer Introductions
 Introductions:
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Name
Role
Office
One thing you hope to walk away with
today
AGENDA
 Welcome
 Overview
 Definitions – Secondary Traumatic Stress aka Caregiver
Fatigue vs Burnout
 Neurobiology
 Vulnerability Factors
 Signs and Symptoms
 Assessment tool
 Self-awareness and self-care
 Practical Tools
 Wrap Up
 Evaluation
OVERVIEW
 Gain a theoretical understanding of secondary traumatic
stress (STS) disorder aka compassion fatigue and burnout.
 Identify signs and symptoms of STS and burnout
 Discuss causes and consequences of STS and burnout with
consideration of social, psychological, spiritual,
biological/neurological, systemic, organizational, and societal
correlates
 Practice some self-administered stress reduction/relaxation
techniques
 Practical Tools
WHY IS THIS TRAINING IMPORTANT?
 Growing literature documenting the impact on front line
workers. High staff turnover.
 Child Welfare Staff are not recognized as first responders
 Despite that, they must react to crisis situations with
incomplete information about what may lie
ahead
 Risks are real–physical and psychological
 Unlike other first responders, they receive
very little public recognition.
 Public focus is often negative
PERSONAL AND ORGANIZATIONAL
IMPACT
 Staf f feel helpless
 Reduced perspective and critical
thinking skills
 Negative world view
 Dif ficulty recognizing and managing emotions
 May under or over react – impaired judgment –
risk to kids
 Factionalism and lack of collaboration
 If several people in a unit are short tempered, argumentative
and pessimistic, people around them are impacted.
 Ultimately, an entire unit or organization can behave like a
traumatized person.
“We have not been directly exposed to the trauma scene, but we
hear the story told with such intensity, or we hear similar
stories so often, or we have the gift and curse of extreme
empathy and we suffer. We feel the feelings of our clients. We
experience their fears. We dream their dreams. Eventually, we
lose a certain spark of optimism, humor and hope. We tire. We
aren’t sick, but we aren’t ourselves.”
C. Figley, 1995
DEFINITIONS
 Secondary Traumatic Stress / Caregiver fatigue: Also called “vicarious
traumatization” (Figley, 1995). The emotional residue or strain of
exposure to working with those suffering from the consequences of
traumatic events.
It differs from burn-out, but can coexist. Compassion Fatigue can occur due to exposure on one case or
can be due to a “cumulative” level of trauma.
 Burnout: Cumulative process marked by emotional exhaustion and
withdrawal associated with increased workload and institutional
stress, NOT trauma-related.
WHAT CAUSES STS/BURNOUT?
Large Group Brainstorm
Identify Causes
Who is at risk?
BURNOUT VS COMPASSION FATIGUE
Commonalities of Burnout and Compassion Fatigue:
 Emotional exhaustion
 Reduced sense of personal accomplishment or meaning in
work
 Mental exhaustion
 Decreased interactions with others (isolation)
 Depersonalization (symptoms disconnected from real causes)
 Physical exhaustion
CLEAR DIFFERENCE
 Burn out emerges over time. Stages include enthusiasm,
stagnation, frustration and apathy.
 Compassion fatigue has a more rapid onset.
 Compassion Fatigue has a faster recovery (less severe, if
recognized and managed early).
COMPASSION FATIGUE TEST
HANDOUT
Take a few moments to complete
Discussion: results and responses
NEUROBIOLOGY
Understanding Basic Neurobiology of
Trauma
Handouts – Brain Basics, Triune Brain,
Hand Model
Freeze, Flight or Fright
Flipping Your Lid
CAN ANYONE RELATE?
BRAIN BASICS
TRIUNE BRAIN MODEL
THE HAND MODEL OF THE HUMAN BRAIN
(DR. DAN SIEGEL)
PRECIOUS VIDEO
https://www.youtube.com/watch
?v=8xQ0rKdiRV0
Notice what comes up……….
Somatic Symptoms
SIGNS AND SYMPTOMS OF COMPASSION
FATIGUE
Brainstorm:
What Behaviors Would You See in a Colleague / Staff
Member or Yourself Experiencing Compassion Fatigue?
 Biological/Physical
 Social
 Psychological
 Handout – Examples of
Compassion Fatigue/Burnout Symptoms
BARRIERS TO ACKNOWLEDGMENT
Brainstorm:
What stops you from speaking up?
What stops your colleagues / staff?
PROFESSIONAL QUALIT Y OF LIFE SCALE
(PROQOL)
Handout PROQOL
Take test
Discuss results
Any surprises?
SELF AWARENESS
 Learn as much as possible – articulate emotions and
reactions
 Know your “triggers”. Learn to defuse or avoid them.
 Resolve your own personal issues! Do your work!
 Be human. Allow yourself to grieve when bad things
happen.
 Develop realistic expectations about the rewards and
limitations of being a child welfare worker.
 Set boundaries for yourself.
 Develop awareness of irrational beliefs
about helping. Make alterations as needed.
 Assess your work / life balance
TOOLS FOR SELF CARE
“ I H AV E N ’ T B R E AT H E D S I N C E L A S T W E E K ”
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Breathing / Grounding and Raising Energy Exercises
Physical Self Care
Emotional Self Care
Psychological Self Care
Spiritual Self Care
Workplace or Professional Self Care
Handout – How to decrease your
vulnerability to compassion fatigue
TOOLS FOR STAFF CARE
 Practice compassion and gratitude toward staff.
 Random acts of kindness.
 Ask staff for input regarding clients who trigger them. Try
to take this into consideration when making case
assignments.
 Actively nurture a sense of community within your unit.
 Remind staff of the meaning in their work. If they’ve lost
it, help them to find it.
 Share information.
 Listen
 Encourage use of personal time.
 Treat staff as adult professionals but don’t be too hands
off.
 Support staff to attend medical appointments.
 Support staff to “do their own work”.
TRY THIS……
Handouts…..
 Stop in Your Tracks….Why am I doing what I’m Doing?
 Think of a Challenging Work Situation….What 3 things makes it
challenging…What 3 things make you appreciate it? Where are
you more likely to focus and why?
 At the beginning and end of each work day, take a distinct
moment to think about what you’re grateful for and why.
 Advocate for your workplace to develop a forum to express
gratitude for one another.
 When your day begins, take several deep breaths….What is my
intention for the day?
 At the end of the day, what can I put down. What do I not need
to carry with me.
 Designate a weekly day of non-obligation for myself. If this is
too much…..what about 10 minutes per day of non-obligation?
OVERCOMING CYNICISM
 This won’t work….I don’t have time…..You don’t understand….
DEBILITATION VS ADAPTION
DO YOU H AVE T H E SKI LLS?
Research shows that people who can do the work successfully
over time demonstrate the following characteristics:
 Sense of personal control – realistic expectations and
personal responsibility.
 Pursuit of personally meaningful tasks - Present and engaged
in life. Ability to be active rather than passive in challenging
times.
 Healthy lifestyle choices – Diet, exercise, relaxation
 Social support – Relationships with others who can serve as a
buf fer when dealing with dif ficult situations.
 Capable of negative affect when faced with adversity but a
belief that actions can resolve problems results in a general
mood of wellbeing.
 Bessel Vander Kolk
WRAP UP
Questions / Answers
Evaluation
THANK YOU
REFERENCES
Marich, J. (2014). Trauma, PTSD & Traumatic Grief: Ef fective
Assessments and Immediate Interventions.
Child Welfare Resource Center for Adoption (2010). Compassion
Fatigue: Secondar y Traumatic Stress Disorder, Burnout,
Vicarious Trauma.
Van Dernoot Lipsky, L & Burk, C (2009). Trauma Stewardship:
An Ever yday Guide to Caring for Self While Caring for
Others.
Additional references cited on handouts