kristen delange ms, lpc, ncc, caadc. introduction outline of the day learning objectives discuss and...
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Kristen DeLangeMS, LPC, NCC, CAADC
IntroductionOutline of the dayLearning Objectives
Discuss and identify the history and causation of secondary traumatization, burn-out, and compassion fatigue and their treatment
Learn and practice tools for self-regulation and relaxation
Cultivate skills necessary to prevent compassion fatigue through increased resiliency
Discuss and identify how to increase support system
Part I: Secondary Traumatization & Self-CareWhy Self-Care and Secondary Traumatization?
“That which is to give off light must endure burning.”-Viktor Frankl
Trauma and PTSDWhat is a traumatic event?
-DSM IV TR (2000)
Posttramatic Stress Disorder
Sympathetic vs. Parasympathetic Dominance
How Our Work Affects Us
What are 3 negative reactions/effects from your work you have experienced?
-Saakvitne & Pearlman (1996)
Key Terms and ConceptsSecondary Traumatization
Burnout
Compassion Fatigue
Jung (1907)
Vicarious Traumatization & Secondary Traumatic Stress“Harmful changes in professionals’ views of
themselves, others, and the world as a result of exposure to the graphic and/or traumatic material of their clients.”
Secondary Traumatic Stress-”a set of psychological symptoms that mimic posttraumatic stress disorder but is acquired through exposure to persons suffering the affects of trauma.”
-Baird et al (2006)
Secondary Traumatic Stress Symptoms
-Gentry (2002)
Causes of STPast traumatic experience(s)ImagesEmpathyCurrent safety concerns of the ones we helpChildrenNature of the work/settingPersonalNew staff
-Saakvitne & Pearlman (1996)
Secondary Trauma VS. PTSD
BurnoutProcess, steadily worsensGradual exposure to work stress and tension,
attrition of optimism and ideals, with a lack of success/accomplishment
Results in exhaustion, isolation, and decreased effectiveness
-Cherniss (1980); Maslach (1976, 1982); Soy (2002)
Compassion Fatigue
Compassion Fatigue =Secondary Traumatization + Burnout
-Figley (1995)
How Can We Heal From This?Healing compassion fatigue-relaxation,
building and maintaining relationships (personal and colleagues), sharing narratives (anonymity)
Healing of burnout-relaxation/self-regulation + changing perceptions and increased work support
VT-Awareness, Balance, Connection-Gentry (2002); Saakvitne & Pearlman (1996)
Healing ExercisesBreathingMindfulness: 3-2-1Assignments:
Mindful eatingJournalFavorite verse(s) regarding God’s character
-Gentry (2009)
Part II: Self-CareReviewMindfulness“Mindfulness can be thought of as moment-to-
moment, non-judgmental awareness, cultivated by paying attention in a specific way, that is, in the present moment, and as non-reactively as possible…mindfulness is perhaps the most basic, the most powerful, the most universal, among the easiest to grasp and engage in, and arguably, the most sorely needed now. For mindfulness is non other than the capacity we all already have to know what is actually happening as it is happening.”
-Kabat-Zinn (2005), pp. 108-109
Mindfulness Cont.observe, describe, participate, non-
judgmental stance, focus on one thing in the moment, be effective
Exercise
-Linehan (1993)
Mindfulness Cont.
Research has shown that mindfulness helps to decrease worry and anxiety, heart problems, substance abuse, depression, stress, smoking urges, insomnia, and chronic pain
Orsillo & Roemer (2011)
Intentionality & Acceptance“Pain is inevitable, suffering is optional”-
FranklRadical Acceptance-Linehan (1993)
4 Ways to Respond to a Crisis:1.Solve it2.Change how you think/feel about it3.Accept it4.Stay miserableAcceptance does not equal agreement or resignation!
Intentionality & Acceptance Cont.What happens when we accept?Pain + Non-acceptance = SufferingPain + Acceptance = Normal PainIntentionality: to address STS symptoms, to
grow professionally and personally, finding balance and taking care of self in order to fully live out God’s calling for our lives.
-Gentry (2009)
My Mission StatementEmpowering, represents the deepest and
best within yourselfFulfillment of your distinctive gifts to
contribute and fulfill God’s call on your life (in all areas)
Vision + ValuesWritten to inspire you and you alone
Taking Physical CareBreathe!Exercise-Aerobic 3x/week or more + anaerobicSleepNutritionSpend time outdoorsMassage, stretch, acupuncture, progressive
muscle relaxationRelaxation-HR, muscle tension-Howard, P. (2006); Severin, S. & Severin T.
(2005)
Taking Spiritual CareReading the Word, studying, committing it to memory PrayerMeditation and Listening (solitude)FastingWorship StewardshipSubmissionServiceConfessionGuidanceCelebration-Foster (1978)
Taking Emotional CareSupport, Support, Support!
IndividualGroupColleagues & SupervisorsLoved OnesPersonal Therapy CreativityHave fun!
ExercisesToxic Waste DumpReclaimingLetter
-Saakvitne & Pearlman (1996)
MaintenanceWhy maintain our commitment?
I am in painI matterThe ones I help matterThe ones I love matterThe work I do mattersIt is imperative
-Saakvitne & Pearlman (1996)
Maintenance Cont.How can we maintain our commitment?
Not on your own: support person/groupOne day at a timeDo something in each areaMake one change at a timeIncrease acceptance and mindfulnessRealistic and non-judgmentalDon’t forget, don’t give up-Saakvitne & Pearlman (1996)
Maintenance Cont.Obstacles?
Solutions?
Taking a Personal InventoryMake note of personal vulnerabilities
Resiliency Plan
Final ExerciseWhat we do well & the rewards of our work Thank you!
ReferencesAmerican Psychiatric Association: Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, D.C. American Psychiatric Association, 2000.
Baird, K., & Kracen, A.C., “Vicarious Traumatization and Secondary Traumatic Stress: A research synthesis.” Counselling Psychology Quarterly, Volume 19, Number 2, June 2006 , pp. 181-188(8). Routledge, part of the Taylor & Francis Group.
Cherniss, C. (1980). Professional Burnout in Human Services Organizations. New York: Praeger.
Figley, C. R., (1995). Compassion Fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Bruner/Mazel.
Foster, R. (1978). Celebration of Discipline. New York: Harper Collins.
Frankl, V. (1963). Man’s Search for Meaning. New York: Washington Square Press, Simon and Schuster.
References Cont. Gentry, J. E. “Compassion Fatigue: A crucible of
transformation.” Journal of Trauma Practice, Spring 2002.Gentry, J.E. (2009). “Compassion Fatigue” from PESI.Gentry, J.E. (2009). “Trauma: Tools for Stabilization and
Recovery” from PESI.Howard, P. (2006). The Owner’s Manual for the Brain, 3rd
Ed. Austin, TX: Bard Press. Jung, C.G. (1907) The Psychology of dementia praecox.
Read, M. Fordham, G. Adler and W. McGuire (eds.), The Collected Works of C.G. Jung, H. Vol. 3. Bollingen Series XX, Princeton: Princeton University Press.
Kabat-Zinn, J. (2005). Coming to Our Senses: Healing ourselves and the world through mindfulness. New York: Hyperion.
References Cont.Linehan, M. M. (1993). Skills Training Manual for Treating
Borderline Personality Disorder. New York: The Guilford Press.
Maslach, C. (1976). “Burnout.” Human Behavior, 5, 16-22.Maslach, C. (1982). Understanding Burnout: Definitional
issues in analyzing a complex phenomenon. In W.S. Paine (Ed.) Job Stress and Burnout: Research, theory and intervention perspectives (pp. 29-40). Beverly Hills, CA: Sage Publications.
Orsillo, S. & Roemer, L. (2011). The Mindful Way Through Anxiety. New York: The Guildford Press.
Saakvitne, K.W., & Pearlman, L.A. (1996) Transforming the Pain: A workbook on vicarious traumatization. New York: Norton.
Severin, S. & Severin, T. (2005). TriEngergetics: Balancing nutrition, exercise, and mindfulness. Oakland, CA: New Harbinger Publications, Inc.
References Cont.Smith, J. (2012). “Dialectical Behavior
Therapy 5-Day Comprehensive” by MACMHB.Soy, S. (2002). “Communication, Social
Support, and Burnout: A Brief Literature Review.” World Wide Web:
http://www.ischool.utexas.edu/~ssoy/pubs/micro-communication/2micro.htm
Covey, S. R., Merrill, A.R., & Merrill, R.R. (1997). First Things first. New York: Simon & Schuster.