10/20/2011. The Journey from Compassion Fatigue to

Transcription

1 Helpingthe Helpers: The Journey from Compassion Fatigue to Resilience Cynthia Vrabel MD 1

2 Objectives: Define the concept of compassion fatigue and identify factors which h may contribute t to it s development. Recognize common manifestations of compassion fatigue. Describe practical strategies which promote personal, professional and organizational resilience. 2

3 A Moment for Reflection: What drew you to this work? What is the best thing about your work? What is the most challenging thing about your work? What do you do to cope with job stress? 3

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6 Compassion Fatigue aka: Secondary Traumatic Stress Vicarious Trauma Battle Fatigue/Combat Fatigue 6

7 Injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whateveraffects affects one directly, affects all indirectly. Martin Luther King Jr. 7

8 Compassion Fatigue: (Figley,1995) The work of helping traumatized people is gratifying i but also bi brings risks. ik Hl Helpers can experience pain as a direct result of exposure to other s traumatic material. The Cost of Caring. 8

9 Pearlman and Saakvitne, 1995 Vicarious trauma is the transformation in the inner experience of the therapist t that t results from empathic engagement with a client s trauma material. Empathy = lowering resistance orseparation Empathy = lowering resistance or separation to allow a connection with another s experience. 9

10 Compassion Fatigue Key Concepts: The emotional residue of working with suffering clients. The effects are cumulative. A normal reaction to an abnormal situation. 10

11 Compassion Fatigue vs Burnout: Burnout is a stage of extreme dissatisfaction with one s work characterized dby excessive distancing, impaired competence and irritability. The nature of the workplace not the nature of The nature of the workplace not the nature of the work. 11

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13 The Impact of Compassion Fatigue: Manifests in the cognitive, behavioral and emotional life ofthe helper. Individualized Dynamic 13

14 Cognitive Manifestations of Compassion Fatigue: Alterations in Cognitive Schema especially relating to safety and relationships. Hypervigilence Intrusive Thoughts about clients which disrupt the hl helpers personal life. Disillusionment 14

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16 Cognitive Manifestations of Compassion Fatigue: Extreme Cynicism Self Blame, Feelings of Failure, Guilt Impairments in Memory and Concentration Grandiosity 16

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18 Behavioral Manifestations of Compassion Fatigue: Avoiding Clients or Over serving clients Boundary Crossings Isolating Exhaustion Diminished Creativity 18

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20 Behavioral Manifestations of Compassion Fatigue: Absenteeism/Tardiness Addictions: Food, Alcohol, Caffeine, Nicotine Excessive Complaining: an indicator of feelings of powerlessness Working all the time: giving up personal life to make more time for work. 20

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22 Anxiety Sadness Emotional Manifestations of Compassion Fatigue: Hopelessness/Helplessness p Numbing Anger/Fear Irritability 22

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25 The Role of Exposure in the Development ofcompassionfatigue: How one is exposed is not as important as the extent to which the helper takes in the material. Taking in refers to a process where the normal ego defenses which allow some distance from what is heard or observed are weakened. The unique connection between survivor and helper. 25

26 Lack of Experience. Compassion Fatigue Contributing Factors: Trauma Caseload: Hours per week spent with traumatized clients. Exposure to Child or Sexual Assault Victims. Low Level of Social Recognition. Pi Primary Trauma in the Workplace. 26

27 Compassion Fatigue Individual Vulnerabilities: Personal Trauma History Coping Style Locus of Control Current Life Situation 27

28 Compassion Fatigue Self Assessment Tools: Compassion Satisfaction/Fatigue Self Test for Helpers (Figley,1995) Professional Quality of Life Scale ProQOL Version 5 (Hudnall Stamm, 2009) 28

29 Trauma Stewardship: A Map for the Journey We create space for and honor others suffering but do not assume their pain as our own. We care for others but we do not take on their path as our path. We maintain i a long term strategy t that t allows us to remain whole and helpful to others. Lipsky (2009) 29

30 Resilience: The power to cope with adversity and adapt to challenges orchange change. The ability to return to healthy functioning after being in a stressful situation. Emerging from stressful situations feeling normal and perhaps even stronger than before. 30

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32 Resilience: Strength Based Promotes growth Dynamic Process of Prevention or Recovery 32

33 Resilience Core Elements: Self Knowledge and Insight. Sense of Hope. Healthy Coping. Strong Relationships. Personal Perspective and Meaning. 33

34 Personal Resilience Operationalizing Self Care A Set of Learned Behavioral Competencies A Consistent, Daily Restorative Practice 34

35 Personal Resilience: Self Care is not Selfish! By validating ourselves we promote acceptance. By meeting our own mental, physical and emotional needs, we give care from a place of abundance, not scarcity. 35

36 Operationalizing Self Care: Awareness Balance Connection DischargeWhat is Harmful Embrace What is Helpful 36

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38 Awareness Mindfulness and Acceptance. Mindfulness paying attention in a particular way: on purpose, in the present moment, and non judgmentally. (Jon Kabat Zinn) An Exquisite Quality of Being. 38

39 Awareness 39

40 Balance 40

41 Connection 41

42 Discharge 42

43 Embrace 43

44 A Personal Resiliency Plan Practice Gratitude Create a Transition Zone Develop a Self Care Tool Kit Time: To Relax Time: To Relax To Have Fun To Create 44

45 Gratitude 45

46 Professional Resilience: Education: Trauma informed, Job specific, User friendly fi and Regularly l Shdld Scheduled. Individual id and Group Supervision: i Clinical i l Problem Solving and Active Support. Professional Organizations 46

47 Organizational Resilience: Organizations have an ethical duty to address the issue of Compassion Fti Fatigue. Provision of a safe place for staff to address Compassion Fatigue. Support following traumatic events. Caseload management Necessary tools and resources to do the job. Employee benefits which h facilitate t self care. 47

48 A Moment for Reflection: As you reflect on our discussion, are there changes you plan to make? Say to yourself what you would be; then do what you have to. Epictetus 48

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50 Education is an admirable thing, but it is well to remember from time to time that nothing that is worth knowing can be taught. ht Oscar Wilde 50

51 Contact Information: inc.org inc.org 51