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  • Compassion FatigueCompassion FatigueCompassion Satisfaction

    Presenter: Barbe Creagh, PhD,LCSW FAMI FTLCSW, FAMI, FT

  • Stressors in Healthcare

    Reduced administrative overhead Increased paperwork Increased paperwork Increased workloads

    l f Elimination of support systems Short-term savings, but long-term costs Impact on staff morale Quality of care Quality of care

  • Compassion Fatigue: The Cost of p gCaring

    Compassion Fatigue (FT) Compassion Fatigue (FT)

    d ( ) Secondary Traumatic Stress (STS)

    Vicarious Trauma (VT)

  • Common Factors


    Secondary exposure to extremely stressful events

    Symptoms-rapid onset and associated with Sy pto s ap d o set a d assoc ated ta particular event

  • Compassion Fatigue

    a natural consequence of working with people who have experienced extremelypeople who have experienced extremely stressful events

    develops as result of providers develops as result of provider s exposure to there patients experiences combined with empathy for therecombined with empathy for there patients.

    (Figley 1995)(Figley, 1995).

  • Vicarious traumatization

    Effect that working with individuals who have experienced trauma have on staff.have experienced trauma have on staff.

    the transformation or change in a the transformation or change in a helpers inner experience as a result of responsibility for and empathicresponsibility for and empathic engagement with traumatized clients.

  • Signs and symptoms of the cost g y pof caring

    Physical Emotional PsychologicalIrritability Grief Changes in life y g

    viewSleep Rage Decreased disturbance feeling of

    personal safetyAppetite change Anger Loss of

    professional identityidentity

  • Signs and Symptoms

    Decreased energy

    Powerlessness Increased interpersonal conflicts

    Anxiety Numbness Increasing cynicism

    Breathing d ff l

    Fear Isolation from hdifficulties others

    Rapid h tb t

    Helplessness Low motivationheartbeat

  • Signs and Symptoms contd

    Somatic complaints

    Overly sensitive

    Decreased ability to cope with stress

    Nightmares Depression Negativity

    Hypervigilance Sadness Loss of Faith

    Impaired immune

    Emotional roller coaster



  • Organizational Costs



    Quality of Care

  • Compassion Fatigue Symptoms

    Intrusive Symptoms Thoughts and images associated with clients Thoughts and images associated with client s

    traumatic experiences Obsessive and compulsive desire to helpObsessive and compulsive desire to help

    certain clients Client/work issues encroaching upon personal / g p p

    time Inability to let go of work-related mattersy g

  • Intrusive Symptoms contd

    Perception of survivors as fragile and needing the assistance of caregiver (savior)

    Thoughts and feelings of inadequacy as a caregiver

    Sense of entitlement or special-ness Perception of the world in terms of victims

    and perpetrators Personal activities interrupted by work-related


  • Avoidance Symptoms

    Silencing Response Loss of enjoyment in activities/cessation of j y /

    self care activities Loss of energygy Loss of sense of competence/potency Isolationso at o Secretive self-medication (alcohol, drugs,

    work, sex, food, spending, etc.), , , p g, ) Relational dysfunction

  • Arousal Symptoms Increased anxiety Impulsivity/reactivity

    I d ti f d d/th t (i Increased perception of demand/threat (in both job and environment)

    Increased frustration/anger Increased frustration/anger Sleep disturbance Difficulty concentrating Change in weight/appetite Somatic symptoms (Figley, 1995)

  • Burnout

    Feelings of hopelessness Difficulties in dealing with work Difficulties in dealing with work Difficulty doing your job effectively

    l d melting down Physically emotionally, mentally

  • Four Phases of Stress leading to gburnout

    1. Warning signs. a Emotional in naturea. Emotional in natureb. Feelings of vague anxiety,c. Fatigue, d. Boredom, e. and disinterest with the job

  • Phases of stress contd2. Mild Symptoms

    a. Escalation of early warning signsb. Reduced emotional controlc. Sleep disturbancesd. Muscle achese. Loss of energy and focusf. Nauseag. Social withdrawalh E i f ih. Excessive fatigue

  • Phases of stress contd

    2. Entrenched symptoms

    a. prolonged stress reaction

    b. Career, personal, family issues

  • Phases of stress contd

    Symptoms include Skin rashes

    Loss of appetite Muscle weakness

    Increased alcohol intake

    High blood pressure Loss of sexual

    Severe migraines Excessive irritability

    Loss of sexual appetite

    Complete social cess e tab ty Irrational feats Rigidity in thought

    Co p ete soc awithdrawal

    Missed work Rigidity in thought

  • Phases of stress contd4. Debilitating symptoms Destructive phase Coronary disease

    Suicidal feelings Thought disorder

    Diabetes Heart attack

    Uncontrolled crying Very ill person who

    ff Asthma Complete agitation

    suffers Emotionally Mentally

    Constant tension hostility

    Mentally Physically(Schneider, M, 2007)

  • Preventing Burnout Recognize the early

    stages of burnout Strengthen relationships

    with family and friends. Network of peers to

    call. Annual health checks

    Maintain balance between work and personal life. Annual health checks

    and screenings. Exercise and rest

    p Evaluate your workload (Schneider,M., 2007)

    Nonrelated work activities

  • Preventing CF and promoting resiliency Become informed Join Stress study

    Bring your life into balance.

    group Begin exercise

    program today

    Develop artistic or sporting disciplineBe kind to yourselfprogram today.

    Teach others how to support you.

    Be kind to yourself Seek short-term

    treatmentsupport you. Develop your


    treatment (Gentry/Baranowsky,


  • Negative Coping Blame others Look for a new job, buy a new car, get a

    divorce or have an affair Habit of complaining with your colleagues

    Hi l Hire a lawyer Work harder and longer

    S lf di t Self-medicate Neglect you own needs and interests. (Pfifferling & Gilley 2000) (Pfifferling & Gilley, 2000)

  • Positive Coping

    Find someone to talk to Understand that the pain you feel is normalp y Start exercising and eating properly Get enough sleep Get enough sleep Take some time off Develop interests outside of work Develop interests outside of work Identify whats important to you (Pfifferling & Gilley, 2000)(Pfifferling & Gilley, 2000)

  • Compassion Satisfaction

    The pleasure you derive from being able to do your work well.

    Pleasure in helping others through your work Feel positively re your colleaguesp y y g Feel positively re your ability to contribute to

    the work setter and good of society.(Stamm & Stamm, 1997)

  • Compassion Satisfaction

    Caring is in balance.

    Self-care plan in place

    Self-care plan strong enough to balance the stress of the emotional impact and suffering.

  • HeartMath Tools

    Heart Lock-In

    BreatheActivate a feeling of appreciation Activate a feeling of appreciation

    Send feelings of care

  • Positive Coping

    Develop your own self-care plan Spend plenty of quiet time alone Spend plenty of quiet time alone

    Recharge your batteries daily Recharge your batteries daily

    Hold one focused connected and Hold one focused, connected and meaningful conversation each day.

  • The Quick Coherence Technique for Adultsq

    Create a coherent state in about a minute with the simple, but powerful steps of the Quick Coherence Technique Using theQuick Coherence Technique. Using the power of your heart to balance thoughts and emotions, you can achieve energy, mental clarity and feel better fast anywhere Useclarity and feel better fast anywhere. Use Quick Coherence especially when you begin feeling a draining emotion such as frustration, irritation anxiety or anger Find a feeling ofirritation, anxiety or anger. Find a feeling of ease and inner harmony thats reflected in more balanced heart rhythms, facilitating b i f ti d t hi hbrain function and more access to higher intelligence.

  • Quick Coherence will help you find a feeling of ease and inner harmony that will be reflected in your heart rhythms. The heart is a primary generator of rhythm in your body, influencing brain processes that control your nervousbrain processes that control your nervous system, cognitive function and emotion. More coherent heart rhythms facilitate brain function, ll i hi hallowing you more access to your higher

    intelligence so you can improve your focus, creativity, intuition and higher-level decision-creativity, intuition and higher level decisionmaking. When youre in heart-rhythm coherence, you perform at your best what thl t ll b i i th Y f lathletes call being in the zone. You feel

    confident, positive, focused and calm yet energized.energized.

  • You can do the Quick Coherence Technique anytime, anywhere and no one will know youre doing it. In less than a minute, it creates positive changes in your heart rhythms, sending powerful signals to the brain that can improve how youre feeling. Apply this one-minute technique first thing in the morning, before or

    The Quick Coherence Technique for AdultsCreat