understanding compassion fatigue & vicarious trauma · 2018-11-14 · © françoise mathieu...
TRANSCRIPT
© Françoise Mathieu 2014 1
Françoise Mathieu, M.Ed., CCC.
Compassion Fatigue Solutions Inc.
Understanding Compassion Fatigue & Vicarious Trauma
Routledge (2012)
•Crisis intervention
© Françoise Mathieu 2014 2
”[…] the patient's suffering ends at the time of death, but that suffering continues in the minds of the care providers, in their hearts and in their memories.”
Dr David Kuhl “What Dying People Want” (2002)
Vicarious Trauma Accumulation of indirect trauma exposure
changes our view of the world
“An occupational hazard” Saakvitne & Pearlman (1996)
1995 Dr Charles Figley “The cost of caring”
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Compassion Fatigue
•Erosion •Lowered tolerance •Desensitization •Cumulative •Personal & Professional •Caregiver fatigue
Multiple Exposure: Increased Risk
Prior Trauma
Traumatic Grief/Loss
Direct Exposure
Secondary Trauma Compassion
Fatigue
Systems Failure
Burnout
Image courtesy of Dr L.A. Ross, Children’s Institute, Los Angeles
How many helping professionals develop CF/VT?
All studies come to the same conclusions: • Affects the most caring • % of traumatic cases on caseload: the more
traumatic the work = higher incidence of VT • Full time vs part time • Availability of social support is protective • Helper’s own trauma history • Adequate training is protective
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• Emotional exhaustion: 53-69% among oncologists compared to 37.1% among allied health care staff
• Low personal accomplishment: 1/3 of gyneco-oncologists. 50% oncologists "reported feelings of low personal accomplishment”
• Recent study carried out among Florida hospice nurses found that 79 percent of them had moderate to high rates of compassion fatigue and 83 percent of those who did not have debriefing/support after a patient’s death, had symptoms of CF (Abendroth)
• From: Kearney, M.K., et al Self-care of physicians caring for patients at the end of life. JAMA, March 18, 2009 - vol 301, no 11.
Recent Data • Physicians with the highest rates of burnout: E.R., internists, Gps, Neurologists then Onco (Shanafelt study) • US Surgeon suicidal ideation: 6.5% in the last 12 months. ¼ sought psychiatric help, 60% of those with SI reluctant to seek help due to fear of repercussions (Shanafelt, 2011) • Nurses: high rates of physical assault, substance use, role overload
The work that you do •Where do those stories go at the end of your day? •What are your vulnerabilities? •How do you protect yourself? Were you trained to do this work?
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Are we trained to do the work we do?
Is Self Care Enough…?
Bober & Regehr Study, 2006
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Bober & Regehr (2005)
•Believing in self care did not equal more engagement •Doing it did not reduce trauma scores
Kyle Killian, Traumatology, June 2008
Kyle Killian, Traumatology, June 2008
What works? “a constructive and supportive
team”
Organizational changes which offer “better working
conditions, more control over their schedule, good quality supervision and a
reduced exposure to trauma.”
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Burnout, depression and addiction in service providers
continue to be taboo topics
Stigma
John Bradford
Research started showing that reducing workload was a good place to start…
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Problem is….
What works? Identify your warning signs
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The Warning Signs Continuum
Symptoms of Chronic Stress •lack of sleep •anxiety •depression •headaches •abdominal pain/GERD/IBS •back pain •eye twitch •bruxing (teeth grinding) •hives •anger, mood swings •poor concentration, forgetfulness •hypertension •cardiovascular disease Image: sixninepixels / FreeDigitalPhotos.net
Behavioural Signs and Symptoms
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Self-Medicating
Behavioural Signs and Symptoms
Increased use of alcohol and drugs
Anger and Irritability
Avoidance of patients/clients
Absenteeism Impaired ability to make decisions
Problems in personal relationships
Attrition Compromised care for patients
Forgetfulness
Psychological signs and symptoms Con’t
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What works?
Get more training
What works? Cultivating Resiliency
Mindfulness Based Meditation
Randomized trials have shown that
mindfulness meditation [is]
effective in reducing Compassion Fatigue
(Kearney 2009)
Michael Kearney, MD Santa Barbara Cottage Hospital
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What works? Organizational and Systemic Changes
Individual
Organization
Professional
Source: Saakvitne & Pearlman (1996)
Healthy Organizations What works?
•Grounded practitioners •Supportive Managers •Well trained managers •Reduced exposure to trauma •Timely debriefing •Good quality supervision •Ability to control schedule
“Horizontal violence”- a direct result of Compassion fatigue and role overload
The toxic workplace
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• Get more training in trauma- informed care
• Develop and enhance your social supports
• Identify your warning signs • Develop a wellness practice and
grounding skills • Advocate for change • Decide what you can control
What works?
www.cfconference.com
Apply to present! Deadline January 2015
