Replenishing the Replenishing the Wellspring: Exploring Wellspring: Exploring

Counselor Wellness and Counselor Wellness and ResiliencyResiliency

Presented by Elizabeth Venart Presented by Elizabeth Venart (2008)(2008)

Power Point information developed by Elizabeth Power Point information developed by Elizabeth Venart and the American Counseling Venart and the American Counseling

Association’s Task Force on Counselor Wellness Association’s Task Force on Counselor Wellness & Impairment & Impairment

Replenishing the Replenishing the wellspring wellspring IntroductionIntroduction

• Background Background

• ACA Taskforce on Counselor Wellness & ACA Taskforce on Counselor Wellness & ImpairmentImpairment

• Program focus on interaction and reflectionProgram focus on interaction and reflection

AgendaAgenda

• Why we need well counselorsWhy we need well counselors

• Risk factors for helping professionalsRisk factors for helping professionals

• Research on counselor wellnessResearch on counselor wellness

• Assessment toolsAssessment tools

• How counselors can enhance their How counselors can enhance their wellnesswellness

• Organizational considerationsOrganizational considerations

• New York’s Counselor ImpairmentNew York’s Counselor Impairment ProgramProgram

Replenishing the wellspringReplenishing the wellspring

• What is meant by counselor What is meant by counselor wellness and resiliency?wellness and resiliency?

• Why is it essential that we prioritize Why is it essential that we prioritize our own wellness—as counselors our own wellness—as counselors and substance abuse professionals? and substance abuse professionals?

Why is wellness important for Why is wellness important for counselors?counselors?

““It is not possible It is not possible

to give to others to give to others

what what youyou do not possess” do not possess”

(Corey, 2000)(Corey, 2000)

Why is wellness important for Why is wellness important for counselors?counselors?

• Counselor effectiveness depends Counselor effectiveness depends more on the personal characteristics more on the personal characteristics of counselors than on school, training, of counselors than on school, training, or theory (Hanna, & Bemak, 1997)or theory (Hanna, & Bemak, 1997)

• Personal wellness, therefore, has an Personal wellness, therefore, has an impact on counselor effectiveness impact on counselor effectiveness with clients (Skovholt, 2001).with clients (Skovholt, 2001).

Wellness definedWellness defined

• ““Wellness is the hallmark characteristic of those Wellness is the hallmark characteristic of those whose lives achieve the balance between self, whose lives achieve the balance between self, life, and others”—Witmer & Granello 2005life, and others”—Witmer & Granello 2005

• ““Wellness is both . . . an overarching goal for Wellness is both . . . an overarching goal for living and a day-by-day, minute-by-minute way living and a day-by-day, minute-by-minute way of being”—Myers & Sweeney 2005 of being”—Myers & Sweeney 2005

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Why Wellness Is an Why Wellness Is an IssueIssue

• Well-counselors are more likely to produce Well-counselors are more likely to produce well-clientswell-clients– ModelingModeling

– Better able to ConnectBetter able to Connect

– More attentive to emotional and cognitive More attentive to emotional and cognitive contentcontent

– More energy and creativity in sessionMore energy and creativity in session

– Less likely to violate boundariesLess likely to violate boundaries

What is wellness?What is wellness?

• Analogy of the wellAnalogy of the well– A well sustains itself with a continuous flow of water A well sustains itself with a continuous flow of water

when it has sources and is regularly replenished when it has sources and is regularly replenished (Milsum, 1984). The amount of reserve is a far (Milsum, 1984). The amount of reserve is a far more significant indicator of a healthy water supply more significant indicator of a healthy water supply than the force of water at any given moment. than the force of water at any given moment. Without a reserve, the well dries up quickly and is Without a reserve, the well dries up quickly and is no longer able to sustain. Well human beings must no longer able to sustain. Well human beings must have reserves because overall wellness depends far have reserves because overall wellness depends far more on these reserves than on performance at any more on these reserves than on performance at any given moment (Milsum, 1984). given moment (Milsum, 1984).

Replenishing the wellspringReplenishing the wellspring

• What replenishes your wellspring What replenishes your wellspring and sustains your resiliency? and sustains your resiliency?

• What helps to fill your reserve?What helps to fill your reserve?– What do you do to unwind at the end What do you do to unwind at the end

of the day?of the day?– What brings you satisfaction and joy?What brings you satisfaction and joy?– What helps you derive meaning from What helps you derive meaning from

your work? your work?

Definition of impairmentDefinition of impairment

Therapeutic impairment occurs when there is a significantTherapeutic impairment occurs when there is a significantnegative impact on a counselor’s professional functioningnegative impact on a counselor’s professional functioningwhich compromises client care or poses the potential for which compromises client care or poses the potential for harm to the client. Impairment may be due to:harm to the client. Impairment may be due to:• Substance abuse or chemical dependencySubstance abuse or chemical dependency• Mental illnessMental illness• Personal crisis Personal crisis

(traumatic events or vicarious trauma, (traumatic events or vicarious trauma, burnout, life crisis)burnout, life crisis)

• Physical illness or debilitation Physical illness or debilitation

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Impairment in and of itself does not imply unethical behavior. Such behavior may occur as a symptom of impairment, or may occur in counselors who are not impaired.

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Counselors who are impaired are distinguished from stressed or distressed counselors who are experiencing significant stressors, but whose work is not significantly impacted. Similarly, it is assumed that an impaired counselor has at some point had a sufficient level of clinical competence, which has become diminished as described above.

Well ImpairedStressed Distressed

• Professional Wellness involves:Professional Wellness involves:– BalanceBalance– Boundaries/Limit settingBoundaries/Limit setting– Getting support Getting support – Strategies for copingStrategies for coping– Professional trainingProfessional training– Evaluation of own healingEvaluation of own healing– ReplenishmentReplenishment

Models of Wellness: A Holistic Focus

• Environmental (Work Setting) Environmental (Work Setting) Wellness involves:Wellness involves:

– The Physical work settingThe Physical work setting– Value system of work placeValue system of work place– Job tasks & Personnel GuidelinesJob tasks & Personnel Guidelines– Supervisory/Management supportSupervisory/Management support– CollegialityCollegiality

Models of Wellness: A Holistic Focus

Special Risks Special Risks Challenges to WellnessChallenges to Wellness

Skovholt 2001Skovholt 2001

• Our inability to say no-The treadmill effectOur inability to say no-The treadmill effect

• Living in an Ocean of Emotional StressLiving in an Ocean of Emotional Stress

• Ambiguous Professional Loss-Ending before Ambiguous Professional Loss-Ending before the Endingthe Ending

• The Covert Nature of the WorkThe Covert Nature of the Work

• Constant Empathy, Interpersonal Sensitivity, Constant Empathy, Interpersonal Sensitivity, and One-Way Caringand One-Way Caring

Special RisksSpecial RisksChallenges to Wellness Challenges to Wellness

Skovholt 2001Skovholt 2001

• Elusive Measures of Success and Normative Elusive Measures of Success and Normative FailureFailure

• Regulation, Oversight and Control by Regulation, Oversight and Control by External, Often Unknowing OthersExternal, Often Unknowing Others

• Cognitive Deprivation Cognitive Deprivation • Cynical, Critical, Negative Colleagues and Cynical, Critical, Negative Colleagues and

ManagersManagers• Legal and Ethical FearsLegal and Ethical Fears

Special RisksSpecial RisksChallenges to Wellness Challenges to Wellness

Skovholt 2001Skovholt 2001

• Cognitive DeprivationCognitive Deprivation

• Cynical, Critical, Negative Colleagues Cynical, Critical, Negative Colleagues and Managersand Managers

• Legal and Ethical FearsLegal and Ethical Fears

• Practitioner Emotional TraumaPractitioner Emotional Trauma

• Practitioner Physical TraumaPractitioner Physical Trauma

2020

Unreasonably Large Caseloads Unreasonably Large Caseloads Large percent of clients with traumaLarge percent of clients with traumaLarge percent of clients with high risk Large percent of clients with high risk behaviorsbehaviorsAdministrative Supervision Administrative Supervision (as (as opposed to Clinical Supervision)opposed to Clinical Supervision)Current policies interfere with doing Current policies interfere with doing what is best for clientswhat is best for clientsDenial of negative impact of work—or Denial of negative impact of work—or fear of negative evaluation by othersfear of negative evaluation by others

Individual and Systemic Barriers

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Burnout Burnout

Compassion FatigueCompassion Fatigue

Vicarious TraumatizationVicarious Traumatization

When Wellness is Eroded

BurnoutBurnout Maslach, Jackson, & Leiter, 1996Maslach, Jackson, & Leiter, 1996

• Emotional exhaustion, depersonalization & Emotional exhaustion, depersonalization & reduced feelings of personal accomplishmentreduced feelings of personal accomplishment

• Typically attributed to work environment or Typically attributed to work environment or job choicejob choice

• Vacation or a job change helps considerablyVacation or a job change helps considerably

Compassion fatigueCompassion fatigueFigley 1995Figley 1995

• ““A function of bearing witness to the suffering A function of bearing witness to the suffering of others” of others”

• Feeling deep sympathy for another’s suffering—Feeling deep sympathy for another’s suffering—and a desire to alleviate the pain and a desire to alleviate the pain

• Professional Quality of Life Assessment Professional Quality of Life Assessment (ProQOL)—www.proqol.org (ProQOL)—www.proqol.org

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Experiencing the trauma our Experiencing the trauma our clients have suffered, or recalling clients have suffered, or recalling our own past traumas due to the our own past traumas due to the exposure through our clients. exposure through our clients.

Pearlman and Saakvitne, 1995 Pearlman and Saakvitne, 1995

Vicarious Traumatization

Vicarious traumatizationVicarious traumatizationPearlman & Saakvitne 1995Pearlman & Saakvitne 1995

• Changes in the self of the helper as a result of Changes in the self of the helper as a result of empathic connection with the pain of those who empathic connection with the pain of those who have been traumatizedhave been traumatized– Special focus on changes in meaningSpecial focus on changes in meaning– InevitableInevitable– UniqueUnique– CumulativeCumulative– ModifiableModifiable

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And then the most insidious of And then the most insidious of challenges….challenges….

LIFE

When Wellness is Eroded

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What We Know About What We Know About Counselor Impairment from the Counselor Impairment from the

ACA Task Force’s ResearchACA Task Force’s Research

• Survey of the ACA MembershipSurvey of the ACA Membership

Most counselors have known a counselor Most counselors have known a counselor they would consider impaired (63.5%)they would consider impaired (63.5%)

In those cases Supervisors (54.3%) and In those cases Supervisors (54.3%) and Colleagues (64.2%) were also aware of the Colleagues (64.2%) were also aware of the impairmentimpairment

In most cases the impaired counselor did not In most cases the impaired counselor did not receive disciplinary (77.8%) action or receive disciplinary (77.8%) action or therapeutic intervention (73.7%)therapeutic intervention (73.7%)

Well ImpairedStressed Distressed

When asked about their own wellness ACA members reported:

81% - Well 15% - Stressed

4% - Distressed 0% - Impaired

Well ImpairedStressed Distressed

When asked about their colleagues wellness ACA members reported:

47% - Well 33% - Stressed

12% - Distressed 4% - Impaired

Counselor Caseloads

41.123.5

261.5

32

71.6

0

50

100

150

200

250

300

Mean Caseload

Percent of Caseloads that is High-risk

52.2

22.4

34.3

12.1

24.4

32.6

52

12.1

19.3

8.8

0

10

20

30

40

50

60

Trauma Survivors

Self-Injurious /Dangerous

Professional Quality of Life

Burnout – Global Mean 18.37, was significantly LOWER than the published norm (22)

Compassion Fatigue – Global Mean 10.05 was significantly LOWER than the published mean (13)

AND

The Global Mean for Compassion Satisfaction (39.84) was significantly HIGHER than the published mean (37).

Professional Quality of Life

14.2% of counselors scored below the cut score (32) for Compassion Satisfaction

5.2% of counselors scored above the cut-point (28) for Burnout

10.8% of participants scored above cut-point (17) for Compassion Fatigue/Vicarious Traumatization

Support Through Personal Counseling

83% of counselors have sought personal counseling

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5346

18

0

10

20

30

40

50

60

Maintaining Counselor Wellness

Career Sustaining Behaviors

Top 5 CSBs

Maintain sense of humor

Spend time with partner/family

Maintain balance between professional and personal lives

Maintain self-awareness

Maintain sense of control over work responsibilities

Career Sustaining Behaviors

Bottom 7 CSBs

Discuss work frustrations with spouse/partner/family

Engage in formal relaxation activities

Receive regular clinical supervision

Participate in personal therapy

Participate in peer support groups

Discuss work frustrations with friends

Use substances to relax.

Career Sustaining BehaviorsCSBs Practiced by the Most Satisfied

Counselors

Reaching Out

Participate in personal therapyDiscuss work frustrations with friendsParticipate in peer support groupsReceive regular supervision

Finding Support Internally and Externally

Maintain professional distance from clientsDiscuss work frustrations with colleaguesSeek case consultationMaintain regular contact with referral networksEngage in quiet leisure activitiesTurn to spiritual beliefsSpend time alone in self reflectionUse positive self talk

Career Sustaining BehaviorsCSBs Practiced by the Most Satisfied

Counselors

Staying Current and Seeking Renewal

Read literature to keep up-to-dateParticipate in continuing educationDiscuss work frustrations with spouse/partner/familyTake regular vacations

Career Sustaining Behaviors

CSBs Practiced by the Most Satisfied Counselors

Striving for Perspective

Perceive clients problems as interestingDiscuss work frustrations with spouse/partner/familyDiscuss work frustrations with friends.

Career Sustaining Behaviors

CSBs Practiced by the Most Satisfied Counselors

Work Related Strategies

Read literature to keep up to date Participate in continuing education

Maintain professional identityMaintain sense of control over work

responsibilities

Try to maintain objectivity about clientsPerceive clients' problems as interesting

Wellness definedWellness defined

• ““Wellness is the hallmark characteristic of those Wellness is the hallmark characteristic of those whose lives achieve the balance between self, whose lives achieve the balance between self, life, and others”—Witmer & Granello 2005life, and others”—Witmer & Granello 2005

• ““Wellness is both . . . an overarching goal for Wellness is both . . . an overarching goal for living and a day-by-day, minute-by-minute way living and a day-by-day, minute-by-minute way of being”—Myers & Sweeney 2005 of being”—Myers & Sweeney 2005

Assessing Wellness

Professional Quality of Life

http://www.isu.edu/~bhstamm/documents/proqol/ProQOL_vIV_English_Oct05.htm

5F-Wellness Evaluation of Lifestyle

www.mindgarden.com

Physical

Cognitive

Emotional

Social

Spiritual

Balance

Wellness Strategies Across Domains

Physical WellnessPhysical Wellness

• Good nutritionGood nutrition

• Exercise—Finding activities you enjoyExercise—Finding activities you enjoy

• Routine medical careRoutine medical care

• Adequate sleepAdequate sleep

• Movement/stretching during the dayMovement/stretching during the day

Physical WellnessPhysical Wellness

• The impact of stress on physical healthThe impact of stress on physical health

• Strategies to reduce stressStrategies to reduce stress– Deep breathingDeep breathing

– MeditationMeditation

– Setting limitsSetting limits

Cognitive WellnessCognitive Wellness

Definition from Travis & Ryan (2004):Definition from Travis & Ryan (2004):

• The individual’s capacity for insight, intelligent The individual’s capacity for insight, intelligent thought, and creative problem-solving. thought, and creative problem-solving.

• Awareness of one’s thoughts and the interrelationship Awareness of one’s thoughts and the interrelationship between thinking and perception, feelings, body between thinking and perception, feelings, body states, and behavior.states, and behavior.

• Ability to focus and concentrate, think affirming Ability to focus and concentrate, think affirming thoughts, and transform counter-productive thinking thoughts, and transform counter-productive thinking patterns.patterns.

Cognitive wellnessCognitive wellness

• Identifying self talkIdentifying self talk

• Countering counter-productive internalized Countering counter-productive internalized messagesmessages

• Addressing perfectionismAddressing perfectionism

• Learning to be kind to ourselvesLearning to be kind to ourselves

Cognitive wellnessCognitive wellness

• Calming one’s mindCalming one’s mind

• Engaging one’s mind Engaging one’s mind – Reading professional literatureReading professional literature

– Taking a courseTaking a course

– HobbiesHobbies

– TravelTravel

• Getting perspectiveGetting perspective

Cognitive wellnessCognitive wellness

• Celebrating successesCelebrating successes– Noticing small positivesNoticing small positives

– Sharing victories in supervisionSharing victories in supervision

– Keeping a success journalKeeping a success journal

– Creating a “thank you” folder/fileCreating a “thank you” folder/file

Emotional wellnessEmotional wellness

Definition from Travis & Ryan (2004):Definition from Travis & Ryan (2004):

An individual’s awareness and acceptance of their An individual’s awareness and acceptance of their emotions as well as their ability to experience a full emotions as well as their ability to experience a full range of emotions and find constructive ways to range of emotions and find constructive ways to express them.express them.

Reflected in a person’s ability to cry, experience joy, Reflected in a person’s ability to cry, experience joy, accept compliments, acknowledge their fears, say no accept compliments, acknowledge their fears, say no without feeling guilty, and openly express feelings of without feeling guilty, and openly express feelings of love. love.

Emotional wellnessEmotional wellness

Ways to nurture emotional Ways to nurture emotional wellness:wellness:

•Tuning in to our emotionsTuning in to our emotions

•Expressing our emotionsExpressing our emotions

Emotional wellnessEmotional wellness

• Tuning in to emotionTuning in to emotion– Not escape/avoidanceNot escape/avoidance

– Acknowledging our feelingsAcknowledging our feelings

– Spending time with animalsSpending time with animals

– Spending time with healthy childrenSpending time with healthy children

– Watching movies and reading booksWatching movies and reading books

– Spending time in connection & conversationSpending time in connection & conversation

Emotional wellnessEmotional wellness

• Expressing the whole range of emotionsExpressing the whole range of emotions– Sadness, anger, joy, pride, disappointment, Sadness, anger, joy, pride, disappointment,

grief, frustration, happiness, fear, love, etc.grief, frustration, happiness, fear, love, etc.– LaughterLaughter– CryingCrying– Talking Talking – WritingWriting– Music Music

Interpersonal WellnessInterpersonal Wellness

•Prioritizing time with people we Prioritizing time with people we lovelove

•Being authentic & spontaneous Being authentic & spontaneous in our interactions with peoplein our interactions with people

•Ability to ask for and receive Ability to ask for and receive supportsupport

Interpersonal WellnessInterpersonal Wellness

– Spend time with partner, family, Spend time with partner, family, and friendsand friends

– Surround yourself with people Surround yourself with people whose energy is uplifting whose energy is uplifting

– Limit one-way caring relationshipsLimit one-way caring relationships– Share both your challenges and Share both your challenges and

your joysyour joys

Interpersonal WellnessInterpersonal Wellness

– Obtain quality clinical Obtain quality clinical supervisionsupervision

– Get regular case consultationGet regular case consultation– Participate in personal therapyParticipate in personal therapy– Begin a peer support groupBegin a peer support group

Spiritual wellnessSpiritual wellness

• A sense of interconnectedness and/or A sense of interconnectedness and/or connection to something greater than yourselfconnection to something greater than yourself– ““Whatever deeply touches and accesses a person’s Whatever deeply touches and accesses a person’s

soul is his or her religion.”—Bradford Keeney soul is his or her religion.”—Bradford Keeney 20052005

• The importance of meaningThe importance of meaning– What do you find meaningful? What do you find meaningful?

– How can you focus on meaning in your work? How can you focus on meaning in your work?

Spiritual wellnessSpiritual wellness

• PrayerPrayer

• MeditationMeditation

• Qi Gong, Tai Chi, YogaQi Gong, Tai Chi, Yoga

• Quiet time for self-reflectionQuiet time for self-reflection

• Time in natureTime in nature

• Join a spiritual communityJoin a spiritual community

• Read spiritual writingsRead spiritual writings

Wellness in the workplaceWellness in the workplace

• Challenges across setting Challenges across setting

• Building a professional support networkBuilding a professional support network

• Daily practices that promote wellnessDaily practices that promote wellness– Strategies within the dayStrategies within the day

– Strategies within the sessionStrategies within the session

– Balance within the workday and weekBalance within the workday and week

• Dare to vision the “Best of all possible worlds”Dare to vision the “Best of all possible worlds”

BalanceBalance• Balance and variety in work-related tasksBalance and variety in work-related tasks

• Balance within each day and weekBalance within each day and week

• Balance between work and leisureBalance between work and leisure

• Sufficient time with family and friendsSufficient time with family and friends

Developing a “culture of Developing a “culture of wellness”wellness”

• Next steps for individual counselorsNext steps for individual counselors– Ongoing assessment of personal wellnessOngoing assessment of personal wellness

– Assessment of workplace wellnessAssessment of workplace wellness

– Developing concrete plansDeveloping concrete plans

– Building supportive professional networksBuilding supportive professional networks

– Sharing wellness informationSharing wellness information

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• Website URL:Website URL:

http://www.counseling.org/http://www.counseling.org/wellness_taskforce/index.htmwellness_taskforce/index.htm

ACA Task Force on Counselor Wellness & Impairment

Elizabeth Venart’s WebsitesElizabeth Venart’s Websites

• www.counselorwellness.comwww.counselorwellness.com

• www.elizabethvenart.comwww.elizabethvenart.com

• www.theresiliencycenter.comwww.theresiliencycenter.com

Elizabeth Venart Elizabeth Venart Contact InformationContact Information

The Resiliency CenterThe Resiliency Center

602 S. Bethlehem Pike, Bldg. B602 S. Bethlehem Pike, Bldg. B

Ambler, PA 19002Ambler, PA 19002

Phone: 215-542-5004Phone: 215-542-5004

Email: Email: elizabeth@elizabethvenart.comelizabeth@elizabethvenart.com & &

evenart@comcast.netevenart@comcast.net