CANARIES IN THE COAL MINE

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1 CANARIES IN THE COAL MINE Awareness and Growth in Trauma Work Brian Sullivan PhD UQ

2 What we need: IMAGINE... A work setting in which the needs of the caregivers are as carefully nurtured as those of the clients Yet the reality is... increased budget cuts burgeoning caseloads complex accountability demands, etc., etc Brian Sullivan PhD UQ

3 Some timely questions How do trauma workers attend to their own emotional well-being? How can trauma workers protect their most important instrument themselves? How can trauma workers develop passionate and long-lasting commitment for their work? How can trauma workers maintain optimal effectiveness in their work over the span of their careers? Brian Sullivan PhD UQ

4 Some timely questions How can we train trauma workers to attend to their own emotional well-being before problems develop? How can organizations ensure optimal conditions that will show care and concern for the health and well-being of their workers, nurturing them as much as they nurture their clients? Brian Sullivan PhD UQ

5 The Triangle of Stress. Worker - personality, resources, homelife, personal development, professional development Workplace culture, relationships, rules, regulations, support, supervision Work roles, responsibilities, demands, rewards expectations Brian Sullivan PhD UQ

6 Wounded Healers High level of COMPETENCE/expertise EMPATHY with clients and colleagues Capacity to engender HOPE COMPASSION for clients and colleagues Capacity to deeply LISTEN HUMILITY to realise that they are only one part of the healing process Commitment to OWN health and healing Letting go of factors impeding PERSONAL DEVELOPMENT Brian Sullivan PhD UQ

7 Organizational Responsibility Occupational hazard in settings where there are high levels of traumatized clients Organizations and agencies providing services to traumatized clients have a practical and ethical responsibility to address this risk for workers Brian Sullivan PhD UQ

8 TRAUMA Changes our assumptive world post-trauma world is different to the pret-trauma Trauma permanently changes a person s reality Fear and anxiety characterized by vigilance turn life s ordinary hassles and stresses into potentially threatening events A lack of joy and hope compromise the experience of being alive Brian Sullivan PhD UQ

9 Effect on Organization Quality of service and effectiveness down devaluing of clients High staff turnover High absenteeism rates Exhaustion common Brian Sullivan PhD UQ

10 Effect on Organization Loss of enthusiasm, energy, morale, commitment and hope of staff Inexperienced, lesser trained, poorly supervised, and younger staff more at risk Beware: the more distressed the client group, the more distressed the organization? Brian Sullivan PhD UQ

11 Personal Knowledge = Emotional Toll (up to 80% of trauma survivors may develop symptoms of PTSD) Widespread devastation Loss of life Oppression Abuse Violence Injustice Hopeless Overwhelmed Cynical Numb Isolated Brian Sullivan PhD UQ

12 Burnout 1. Emotional exhaustion 2. Negative attitude towards clients 3. Reduced personal achievement and commitment to work 4. Symptoms can include depression, negativity, demoralization, discouragement, physical and emotional fatigue, and feelings of incompetence Brian Sullivan PhD UQ

13 OUTCOMES OF BURNOUT Exhaustion Diminished competence Negative work environment Devaluing of client Deteriorating personal life (Burnout is multidimensional) Brian Sullivan PhD UQ

14 How organizations contribute to burnout an unsupportive administration; untrustworthy management; low salaries and high work demands; and unrealistic work expectations (Bell, Kulkarni & Dalton, 2003). Brian Sullivan PhD UQ

15 6 Key Areas of Worklife a) Manageable workloads; b) A sense of control; c) Opportunity for rewards; d) A sense of belonging and community; e) Trust in the fairness of the workplace; f) Shared values (Maslach & Leiter, 1997, 1999) Brian Sullivan PhD UQ

Vicarious Trauma - our occupational hazard We risk VT through empathic contact with traumatized people Intrusive imagery (nightmares etc) Lower levels of trust Lack of feeling

16 Vicarious Trauma - our occupational hazard We risk VT through empathic contact with traumatized people Intrusive imagery (nightmares etc) Lower levels of trust Lack of feeling in control Issues of intimacy Esteem may drop Not feeling safe Depression and grief Feeling powerless Potential for worker error Feeling stuck, etc. Brian Sullivan PhD UQ

17 Vicarious Traumatization Vicarious traumatization may also include some post-traumatic stress related symptoms including exhaustion and impaired functioning, intrusive thoughts and nightmares, avoidance and numbing, hypervigilance and persistent arousal. Workers can show emotional, physical, behavioural, work-related, and interpersonal problems (Trippany, Kress, & Wilcoxon, 2004). Brian Sullivan PhD UQ

18 Organizational Responsibility and Personal Imperative Prevention Intervention Brian Sullivan PhD UQ

19 Organizational Responsibilities Acknowledge that vicarious trauma is a real workplace health and safety issue, and warn job applicants for trauma worker positions Assess and monitor workers resiliency. Provide adequate training on ongoing professional development for workers Provide supervision and consultation individual and peer Brian Sullivan PhD UQ

20 Organizational Responsibilities Develop a respectful and sensitive work environment Develop supportive work teams Provide sufficient resources for workers to do trauma work Provide sufficient rewards, praise and encouragement for counsellors Acknowledge and celebrate successes Brian Sullivan PhD UQ

21 Organizational Responsibilities Ensure adequate salaries and benefits for workers Provide a safe, supportive workplace Provide access to personal counselling and support for workers who require it. Provide a variety of roles in job descriptions apart from constant face-to-face trauma work. Ensure sufficient recreation leave, sick leave, and leave for personal and family needs. Brian Sullivan PhD UQ

22 Organizational Responsibility 1. Workplace culture 2. Workload 3. Work environment 4. Education 5. Group support 6. Supervision 7. Resources for self-care Brian Sullivan PhD UQ

THE SELF Self-reflection/awareness introspection, mindquietening, reviewing and evaluating your human experience, awareness of thoughts and feelings Self-care maintaining life, healthy functioning,

23 THE SELF Self-reflection/awareness introspection, mindquietening, reviewing and evaluating your human experience, awareness of thoughts and feelings Self-care maintaining life, healthy functioning, continuing personal development, and well being Self-transcendence our ability to rise and go beyond oneself, to extend beyond personal concerns, to take a broad life perspective and meaning, to rise above adversity (with our vital adaptive spirit ). Brian Sullivan PhD UQ

24 SELF CARE We pay a price for the stories we hear! What are your: SAFETY NEEDS? TRUST NEEDS? INTIMACY NEEDS? CONTROL NEEDS? ESTEEM NEEDS (yours and others)? Brian Sullivan PhD UQ

25 SELF CARE Prevention/Intervention Acknowledging that vicarious trauma is a real workplace health and safety issue for the self. Accepting emotional reactions to trauma as normal in this line of work. Engaging in physically healthy and leisurely activities outside of work (this doesn t include abusing alcohol or drugs). Ensuring you have adequate rest and sleep. Seeking out counselling for your own trauma related issues. Seeking out experiences which instil hope, meaning, and emotional and spiritual comfort to you. Brian Sullivan PhD UQ

26 SELF CARE Prevention/Intervention Seeking out meaningful supervision and consultation where you can discuss your reactions to your work. Developing supportive relationships inside and outside the workplace avoiding isolation. Setting clear boundaries between work and home. Setting clear client limits on your accessibility and the client relationship. Developing your professional skills trauma and nontrauma related. Take holidays Brian Sullivan PhD UQ

27 SELF CARE Prevention/Intervention Living a therapeutic lifestyle means: Attending to relationships Attending to personal physical health Attending to personal spiritual needs Attending to your place in nature Attending to your needs for creativity and recreation Brian Sullivan PhD UQ

28 Self-care Responsibility 1. Exercise 2. Nutrition and Diet 3. Nature 4. Relationships 5. Stress Management and Relaxation 6. Recreation and Enjoyment 7. Spirituality, Meaning, Purpose 8. Contribution and Service Brian Sullivan PhD UQ

29 Some more QUESTIONS 1. What am I doing about my own experience of personal trauma? 2. How is this hindering or helping clients? 3. How can we give our workers an ongoing positive experience of supervision? 4. What ongoing training do we need to do this work effectively? 5. How am I caring for myself in this work knowing the risks involved? Brian Sullivan PhD UQ

30 VICARIOUS GROWTH What doesn t kill you, can make you stronger Personal growth Meaning and purpose Resilience Appreciation Hope Wisdom Inspiration There are men, women, and children alive and thriving today because of you Brian Sullivan PhD UQ

31 Vicarious Growth Compassion satisfaction (not fatigue) Improved relationships Gratitude New possibilities for one s life Acknowledging and accepting personal limits Greater sense of personal strength/resilience Spiritual development Brian Sullivan PhD UQ

32 VICARIOUS GROWTH Self-awareness, self-monitoring, self appraising (Noticing and listening for your own inner canary) Empathic stamina... Sustaining capability... Acknowledging and accepting your own personal limitations (the good news is that you are not the messiah!). Brian Sullivan PhD UQ

33 Vicarious Growth if you are going to be selfish, be wisely selfish which means to love and serve others, since love and service to others bring rewards to oneself that otherwise would be unachievable (Dalai Lama) Providing social support may be more beneficial than receiving it (Brown, Nesse, Vinokur, & Smith, 2003) Brian Sullivan PhD UQ

34 THE GREATEST GIFTS Balance and wholeness are the greatest gifts I can give to myself (Charles Cannon) Ensure your organization, agency, or department offers you this gift too! I came to explore the wreck... I came to see the damage that was done And the treasures that prevail (Adrienne Rich, 1973, from Diving into the Wreck) Find your treasures in this trauma work for your own growth and development Brian Sullivan PhD UQ

35 Final thoughts With thoughtful self care and organizational care, we can grow in meaning and purpose, cultivating an awareness of human resilience in general and client strengths in particular, and believing in the possibility of growth and recovery, (Jenmorri, 2006, p. 50). Brian Sullivan PhD UQ

Learning objectives addressed Describe various responses among helpers working with survivors of trauma.

Learning objectives addressed Describe various responses among helpers working with survivors of trauma. 1 2 3 4 Describe various responses among helpers working with survivors of trauma. Research has shown that some professionals and adults working with survivors of trauma are often affected by the experiences