reactions to secondary traumatic exposures.ppt
TRANSCRIPT
Reactions to Secondary Reactions to Secondary Traumatic ExposuresTraumatic Exposures
Dorothy Morgos, PH.DDorothy Morgos, PH.DUNMIS Staff CounselorUNMIS Staff CounselorAhfad University, 2010Ahfad University, 2010
What is Secondary Traumatic What is Secondary Traumatic Exposure?Exposure?
Exposure to traumatic material when working with traumatized individualsExposure to traumatic material when working with traumatized individuals
Traumatic situations are not a direct threat to helpers themselvesTraumatic situations are not a direct threat to helpers themselves
Exposures are common among:Exposures are common among:Trauma counselorsTrauma counselorsRescue workersRescue workersHumanitarian workers/crisis intervention volunteersHumanitarian workers/crisis intervention volunteersMedical workersMedical workers
Exposures range from a single episode to frequent and high intensityExposures range from a single episode to frequent and high intensity
Reactions to Secondary Traumatic Reactions to Secondary Traumatic ExposuresExposures
Range from stressful to full blown traumatic reactionsRange from stressful to full blown traumatic reactions
Could be both short and long termCould be both short and long term
General terms used to describe a range of reactions:General terms used to describe a range of reactions:– Emotional exhaustionEmotional exhaustion– Burn outBurn out– Compassion fatigueCompassion fatigue
Traumatic reactions are usually called Vicarious Trauma Traumatic reactions are usually called Vicarious Trauma (VT) or Secondary Trauma (ST)(VT) or Secondary Trauma (ST)
Differences Between Burnout and Differences Between Burnout and Vicarious Trauma (VT)Vicarious Trauma (VT)
Burnout SymptomsBurnout Symptoms
Result of general stress in a working environmentResult of general stress in a working environment
Feeling overloaded secondary to workloadFeeling overloaded secondary to workload
Feeling overwhelmed by clients problems of chronicity and Feeling overwhelmed by clients problems of chronicity and complexitycomplexity
Gradual progression of “emotional exhaustion”Gradual progression of “emotional exhaustion”
Does Does NOTNOT usually lead to usually lead to Changes of core believes known as “cognitive schema”Changes of core believes known as “cognitive schema”Safety concernsSafety concernsSignificant relationship difficultiesSignificant relationship difficulties
What are Traumatic ReactionsWhat are Traumatic Reactions
Traumatic reactions are a higher level of stressful symptoms Traumatic reactions are a higher level of stressful symptoms
Common term is Posttraumatic Stress Disorder ( PTSD)Common term is Posttraumatic Stress Disorder ( PTSD)
Symptoms are usually present for at least one month or more when Symptoms are usually present for at least one month or more when stressful event is no longer presentstressful event is no longer present
Intrusive reactions:Intrusive reactions:– Dreams/nightmaresDreams/nightmares– FlashbacksFlashbacks– Obsessive thoughtsObsessive thoughts– Physiological reactionsPhysiological reactions– Persistent re-experiencing of eventPersistent re-experiencing of event
What are Traumatic Reactions What are Traumatic Reactions Cont..Cont..
Hyper-Arousal Reactions:Hyper-Arousal Reactions:Hyper-vigilanceHyper-vigilance
Difficulty concentratingDifficulty concentrating
Avoidant Reactions:Avoidant Reactions:General numbing in responsiveness General numbing in responsiveness
Avoidant behaviors related to traumatic situations Avoidant behaviors related to traumatic situations
Symptoms are usually pervasive in nature Symptoms are usually pervasive in nature
What is Vicarious TraumaWhat is Vicarious Trauma
The inner transformation that occurs in the inner The inner transformation that occurs in the inner experience of the professional that comes about as a experience of the professional that comes about as a result of empathic engagement with the clients “trauma”result of empathic engagement with the clients “trauma”
Cumulative in natureCumulative in nature
May parallel those experienced by the traumatized May parallel those experienced by the traumatized victimsvictims
More common among those who work with traumatized More common among those who work with traumatized populationpopulation
What is Vicarious Trauma Cont..What is Vicarious Trauma Cont..
Key Characteristics include:Key Characteristics include:
Feeling helpless/hopeless regarding taking care of Feeling helpless/hopeless regarding taking care of themselves and othersthemselves and others
Disillusionment about concepts of justice and freedomDisillusionment about concepts of justice and freedom
Change in person’s beliefs ( Cognitive schema)Change in person’s beliefs ( Cognitive schema)SelfSelf
OthersOthers
WorldWorld
Characteristics of Vicarious Trauma Characteristics of Vicarious Trauma Cont…Cont…
Mood disturbance ( e.g. anxiety, depression)Mood disturbance ( e.g. anxiety, depression)
De-personalizationDe-personalization
Feeling of reduced personal accomplishmentsFeeling of reduced personal accomplishments
Change in “psycho-social” relationshipsChange in “psycho-social” relationships
Increased feelings of cynicism, sadness or seriousnessIncreased feelings of cynicism, sadness or seriousness
Increased sensitivity towards violenceIncreased sensitivity towards violence
Distrustful and alienationDistrustful and alienation
Alcohol and drug abuseAlcohol and drug abuse
Impact of Vicarious TraumaImpact of Vicarious Trauma
OrganizationsOrganizations
High worker turnoverHigh worker turnover
Ongoing conflicts within and between organizationsOngoing conflicts within and between organizations
Poor productivity and/or over conscientiousPoor productivity and/or over conscientious
Re-enactment of issuesRe-enactment of issuesBetrayalBetrayalSecrecySecrecyMistrustMistrustRageRageBoundary violationsBoundary violations
Impact of Vicarious Trauma Impact of Vicarious Trauma Cont..Cont..
When working with traumatized individualsWhen working with traumatized individuals
Clinical errors and impassesClinical errors and impasses
Compromising boundaries with victimsCompromising boundaries with victims
Anger towards clientsAnger towards clients
Doubts in judgment/assessment and techniquesDoubts in judgment/assessment and techniques
Loss of focus on individual’s resilienceLoss of focus on individual’s resilience
Avoidance or untimely intrusiveness when going in depth with Avoidance or untimely intrusiveness when going in depth with traumatized individualstraumatized individuals
Reversal of rolesReversal of roles
Effective Peer Support StrategiesEffective Peer Support Strategies
Use effective listening and assessment skillsUse effective listening and assessment skills
Acknowledge that sharing provides social Acknowledge that sharing provides social supportsupport
Vending avenueVending avenueDecreases sense of isolationDecreases sense of isolationIncreases empathy and compassionIncreases empathy and compassion
Normalization of VT experiencesNormalization of VT experiencesAmends cognitive distortions/disruptionsAmends cognitive distortions/disruptionsIncreases objectivity and empathyIncreases objectivity and empathy
Effective Peer Support Cont..Effective Peer Support Cont..
Provide an avenue to assess ideologiesProvide an avenue to assess ideologiesEthical issuesEthical issuesView of self and othersView of self and othersSpiritual strugglesSpiritual strugglesViews of justiceViews of justice
EducationEducationLearning the different types of traumatic events and their Learning the different types of traumatic events and their impactimpactTraumatic material affects different areas of ones well beingTraumatic material affects different areas of ones well beingIntensity of exposure, personal history and level of training Intensity of exposure, personal history and level of training impact VTimpact VT
Effective Peer Support Cont..Effective Peer Support Cont..
Organizational supportOrganizational support
Reduce case loadsReduce case loads
Provide effective and supportive supervisionsProvide effective and supportive supervisions
Keep supervision separate from evaluationKeep supervision separate from evaluation
Provide debriefing opportunitiesProvide debriefing opportunities
Increase social interactions between co-workersIncrease social interactions between co-workers
Provide respite care system and means for self-careProvide respite care system and means for self-care
Create a non shaming work environmentCreate a non shaming work environment
Encourage staff to provide feedback and suggestions on Encourage staff to provide feedback and suggestions on increasing a “supportive working culture”increasing a “supportive working culture”
Effective Peer SupportEffective Peer Support
Self-Care strategies for VTSelf-Care strategies for VTPhysical self-carePhysical self-care
DietDietExerciseExerciseSleep hygieneSleep hygieneFrequent recreational activitiesFrequent recreational activities
Relying on religious beliefs or spiritualityRelying on religious beliefs or spiritualitySocial support within and outside working environmentSocial support within and outside working environmentSeeking counseling/consultation as neededSeeking counseling/consultation as neededSocio-political involvementSocio-political involvementContinuing educationContinuing educationSustaining professional support outside working environmentSustaining professional support outside working environmentHUMORHUMORIdentifying, reminding oneself and owning successIdentifying, reminding oneself and owning success