agenda · 2018. 11. 16. · compassion fatigue self-assessment 1. personal concerns commonly...
TRANSCRIPT
Agenda 0 Welcome and Introductions
0 Overview • Compassion Satisfaction
• Compassion Fatigue
• Burnout
• Secondary Trauma
0 The Importance of Self-Assessment
0 Practical Ways of Coping: • Personal
• Relationships
• Workplace
0 Professional Quality of Life Scale
0 Resilience and Action Steps
Types of Stress
0 There are at least three different types of stress, all of which carry physical and mental health risks:
0 Routine stress related to the pressures of work, family and other daily responsibilities.
0 Stress brought about by a sudden negative change, such as losing a job, divorce, or illness.
0 Traumatic stress, experienced in an event like a major accident, war, assault, or a natural disaster where one may be seriously hurt or in danger of being killed.
(NIMH, Fact Sheet on Stress. 2014)
Impact of Chronic Stress
0 Most Americans report feeling moderate-to-high stress levels.
0 70-80% of all visits to the doctor are for stress-related and stress-induced illnesses.
0 Stress can play a part in problems such as headaches, high blood pressure, heart problems, diabetes, skin conditions, asthma, arthritis, depression, and anxiety.
(USDHHS: Healthy People; APA: Stress in America Survey; Mayo Clinic: “Chronic stress puts your health at risk.“)
Work Stress
0 Please share an example of a way that work stress has affected you.
0 What were the signs that you were affected by the stress (physical or emotional)?
Please use the chat box.
Reactions to Work Stress in Helping Professions
• Compassion Satisfaction: Positive aspects of working as a helper
• Compassion Fatigue: Negative aspects of working as a helper
• Burnout
– Inefficacy and feeling overwhelmed
• Work-related traumatic stress
– Primary traumatic stress direct target of event
– Secondary traumatic exposure to event due to a relationship with the primary person
(Stamm , 2009)
Compassion Satisfaction
0 The pleasure you derive from being able to do your work.
0 Feel satisfied and enjoy your work
0 Feel positive towards clients
0 Feel you actually are helping others (I make a difference)
0 Feel you are able to keep up with the work
(Stamm, 2012)
Compassion Fatigue “affects those who do their work well” (Figley, 1995)
0 Shift in hope and optimism about the value of the work
0 Deep physical, emotional and spiritual exhaustion
0 Compassion fatigued practitioners continue to give themselves fully to their clients, finding it difficult to maintain a healthy balance of empathy and objectivity.
0 Can be a typical response to work overload; can ebb and flow depending on demands
0 Two components: Burnout and Secondary Trauma
(Mathieu, 2007;Pfifferling & Gilley, 2000)
Burnout
0 Feelings of hopelessness
0 Feelings of being emotionally exhausted and overextended by the work.
0 Feelings of depersonalization which result in negative, cynical attitudes toward clients.
0 Diminished personal accomplishment, reflecting a sense of lowered competence and a lack of successful achievement in work with clients.
0 Associated with high workloads and non- supportive work environment
(Maslach & Jackson, 1986; Stamm, 2012)
Secondary Traumatic Stress
0 Secondary exposure to extremely stressful events (exposure to others’ trauma or reexperiencing the client’s trauma)
0 Symptoms rapid in onset and specific to a particular event
0 Symptoms: Afraid, difficulty sleeping, images of upsetting event, avoiding the client and reminders of the event
(Figley, 1995, Stamm, 2012)
Compassion Fatigue Self-Assessment
1. Personal concerns commonly intrude on my professional role.
2. My colleagues seem to lack understanding.
3. I find even small changes enormously draining.
4. I can't seem to recover quickly after association with trauma.
5. Association with trauma affects me very deeply.
6. My patients' stress affects me deeply.
7. I have lost my sense of hopefulness.
8. I feel vulnerable all the time.
9. I feel overwhelmed by unfinished personal business.
Exercise only – Non-validated tool: http://www.aafp.org/fpm/2000/0400/p39.html
Poll: How many of you answered….
0 Yes to 1 item
0 Yes to 2 items
0 Yes to 3 items
0 Yes to 4 or more
Yes to 4 or more could be possible indicators of Compassion Fatigue.
What is the ?
Compassion
Fatigue
Compassion
Satisfaction
Stress Relief
0 What did you do to relieve the work stress we asked about earlier?
Please chat into the box.
Self-Care Assessment
0 Personal Self-Care Checklist
Personal Self-Care
0 We have stressful experiences everyday in our jobs
0 People are different: What is stressful to you, may not be stressful to others.
0 Strengths comes in identifying the stress and acting to manage it.
0 Checking in about your stress levels on a daily basis can help to make you more aware of what you and your body are going through (e.g., stress thermometer)
Volk, Guarino, Grandin, & Clervil, (2008)
Personal Self-Care
0 Many of us come with issues that are unresolved and can impact our lives and our work
0 Do you have your own history of trauma?
0 Very common
0 What are your triggers?
0 Are you getting help to help you cope?
Volk, Guarino, Grandin, & Clervil, (2008)
Personal Self-Care
0 Key areas to examine:
0 Sleep – most are sleep deprived which makes you more vulnerable to stress
0 Exercise – even a little bit helps; do with a friend
0 Diet – eat regularly or skip meals; healthy foods
0 Unhealthy habits? Caffeine, smoking, drinking excessively
0 Are you maintaining positive relationships?
(Stamm, 2002)
If you only have a few minutes…
Volk, Guarino, Grandin, & Clervil, (2008)
Relationships Help
0 Stress can impact and strain relationships
0 Maintaining positive relationships helps to balance the stress one is experiencing
0 Decades of research have shown that there are tremendous benefits in having a network of supportive relationships.
0 Individuals with robust social support networks have better health and well-being and longer lives.
0 Support networks can make you more resilient in times of stress, setback, or loss.
0 Social supports can also make the good times immeasurably better.
0 Friends can even help you identify when you are stressed or distressed — in some cases they may notice it before you do.
(Volk, Guarino, Grandin, & Clervil, 2008; Stamm ,2002)
Relationships Help
0 What are you doing to build relationships?
0 Are you expanding your support networks?
0 Do you have friends you can speak with about how work affects you?
0 Can you tell your friends and family not to expect you to solve their problems since you are “so good at it”?
Activating your Supports
Once you have identified supports you need to know how to activate these supports. Identify when you need help
Identify how you can ask for help
Ask for what you need
0 Helpful Tool: The “Breathe” supports are people who can be relied upon to notice, before you do, that you are either stressed or distressed. They intervene and offer support.
http://www.socialwork.buffalo.edu/students/self-care/documents/support/Identifying_Your_Breathe_Supports_-_Reiser.pdf
If you only have a few minutes…
Volk, Guarino, Grandin, & Clervil, (2008)
Relationships Help
0 Workplace Relationships 0 Colleagues:
0Colleagues can help listen and provide support 0Colleagues can see you struggling and let you know
0 Supervisors: 0 Support to process challenges and build coping 0Do you feel comfortable with your supervisor? If not, can
you change supervisors or add an outside supervisor?
0 You can also find non-workplace professional communities 0 Look for others in similar profession 0Virtual support groups or professional networks 0Remember confidentiality – share how you feel not your
client’s story
(Stamm, 2002)
Chat Question:
0 How do you seek support from colleagues or supervisors?
0 How do you ask for help?
0 Please use the chat box.
Organization-Wide Stress 0 Warning signs:
0 High rates of staff turn-over
0 High rates of absences or tardiness
0 Lack of communication and frequent miscommunication between co-workers and/or departments
0 Increase in interpersonal conflicts between co-workers and/or between various parts of the organization
0 Missed deadlines
0 Incomplete work
0 Poor quality of work or service delivery
0 Increase in customer/client complaints
0 A negative atmosphere/low morale
0 Less energy and motivation to do “extra” or to take sufficient time to do quality work as an organization
0 A lack of emotional and/or physical safety in the organization Volk, Guarino, Grandin, & Clervil, (2008)
Organization-Wide Stress
0 Organizational Self-Care Checklist
If you only have a few minutes…
Managing Your Workload 0 Can you see a variety of clients (e.g., mixing milder cases with
more intense cases)? 0 Split seeing clients with administrative tasks 0 Can you transition stagnant cases to other services? 0 Plan pockets of time to complete administrative tasks during
your day so you can leave work on time. 0 Have a transition time between seeing clients and going
home. 0At work, end your day with something positive. 0During commute, do something fun/enjoyable unrelated
to work. 0At home, take a few minutes to breathe before
transitioning to home responsibilities (e.g., enjoy family time, listen to music, etc.).
0 Switching on and off – See PocketCard 0 Keep Hope Alive!
(Stamm , 2002)
The Professional Quality of Life Scale (ProQOL)
0 The ProQOL is free and available at www.proqol.org
0 A 30 item self-report measure of the positive and negative aspects of caring
0 The ProQOL measures Compassion Satisfaction and Compassion Fatigue
0 Compassion Fatigue has two subscales
0 Burnout
0 Secondary Trauma
Stamm (2009)
Resiliency Planning
• Individual, personally
– The ProQOL can help you plan where to put your energy to increase our resilience
• Organizational planning
– Can help organizations find ways to maximize the positive aspects and reduce the negative aspects of helping
• Supportive Supervision
– The ProQOL can be used as information for discussions
Stamm (2009)
Action Step!
0 What is one thing you can start doing right away…
0 Personally?
0 Workplace?
0 Please use the chat box!
Resources 0 http://www.compassionfatigue.org 0 http://www.stress.org/ 0 http://www.healthycaregiving.com/ 0 http://www.proqol.org/Home_Page.php 0 Workbook for Those Who Work with Others:
0 http://www.familyhomelessness.org/media/94.pdf
0 Organizational and Personal Self-Care Checklists: 0 http://www.familyhomelessness.org/media/95.pdf
Resources/References 0 Figley, C.R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C.R. Figley (Ed.),
Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1-20). New York: Brunner/Mazel.
0 Figley, C.H. (2002). Treating Compassion Fatigue. New York: Routledge
0 Maslach, C. and Jackson, SE (1986). Maslach Burnout Inventory Manual: Second Edition. Palo Alto: Consulting Psychologist Press.
0 Mathieu, F. (2007).Transforming Compassion Fatigue into Compassion Satisfaction: Top 12 Self-Care Tips for Helpers. Workshops for the Helping Professions.
0 Pfifferling, J. H., & Gilley, K. (2000). Overcoming compassion fatigue. Family Practice Management, 7(4), 39-39.
0 Stamm, B.H. (2002). Quick-guide suggestions prevention/intervention with the negative effects of caregiving. http://www.proqol.org/Handouts.html
0 Stamm, B.H. (2009-2012). The PROQOL: Professional quality of life scale: Compassion satisfaction burnout and fatigue scale-Version V. Retrieved May 13, 2013, from http://www.proqol.org/uploads/ProQOL_5_English_Self-Score_3-2012.pdf
0 Rothschild, B. & Rand, M. (2006). Help for the helper: The psychophysiology of compassion fatigue and vicarious trauma. New York, NY: W. W. Norton & Company.
0 Volk, Guarino, Grandin, & Clervil, (2008). What About You? Workbook for Those Who Work with Others. The National Center on Family Homelessness.
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Lydia Franco, LMSW
Kara Dean-Assael, LMSW