COMPASSION & CONTEMPLATIVE Practice In Social Work. Kirsti Kilbane MSW student Curtin University Bentley WA

Transcription

1 COMPASSION & CONTEMPLATIVE Practice In Social Work Kirsti Kilbane MSW student Curtin University Bentley WA

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4 Practice & Education Standards AASW Code of Ethics (2010): SWs should have respect for others, including compassion (p.9), empathy, [and] reflective self-awareness (p.13) AASW Practice Standards for Mental Health Social Workers (2008): Mental health social workers should bring human qualities of empathy, compassion and hopefulness to their work (p.12). Australian Social Work Education and Accreditation Standards (2012): Mental health curriculum content would be expected to cover empathy, compassion and the importance of conveying hope (p.49).

5 Compassion & Recovery National MH Recovery Framework (2013) Vision for recovery oriented organisations includes: commitment to compassionate, person-centred working (p71) and requires workers to demonstrate "kindness, honesty and empathy (p61). Recent government reports and policy suggest that we are far from providing compassionate care and may be more focused on risk and surveillance, (Lloyd & Carson 2011). (UK) The fostering of hope, which appears to be so central to recovery, needs compassionate relationships and contexts in order to be meaningful and effective (Spandler and Stickley, 2011, p.564).

6 Empathy/ Compassion The crucial distinction between the term empathy and those like sympathy, empathic concern, and compassion is that empathy denotes that the observer s emotions reflect affective sharing ( feeling with the other person) while compassion, sympathy, empathic concern denote that the observer s emotions are inherently other oriented ( feeling for the other person). (Singer & Lamm 2009)

7 Empathy/Compassion in SW All social work practice hinges on the concept that client growth depends on the qualities of the helping alliance, and it is arguably the defining variable of the profession (Biestek, 1957, in King 2011) Empathy has been identified as the single most consistent condition of a productive therapeutic relationship in outcome research (Sinclair & Monk, 2005 in King 2011)

8 Empathy/Compassion in SW The treatment of empathy in social work literature and education has been described as haphazard and narrow (Freedberg, 2007 in Gerdes et al, 2011). Actual research on empathy, as well as empathy training in the social work curriculum, remains scarce and sketchy (Gerdes & Segal 2011). In the last 10 years, social work definitions of empathy have not incorporated new scientific findings. (Gerdes et al 2010 p.2326). Research on empathy in an Australian social work context appears to be minimal (Gair, S. 2010, p.793).

9 Neuroscience of Empathy Affective sharing. The experience of similar emotions between the self and an other, based on automatic shared representations. (mirror neurons) Self awareness. Even when there is some temporary identification between the observer and its target, there is no confusion between self and other. Mental flexibility. The cognitive capacity to imagine another s situation from the inside, to adopt the subjective perspective of the other. Emotion regulation. The regulatory processes that modulate the subjective feelings associated with emotion. (Decety & Moriguchi, 2007, in Gerdes & Segal 2009).

10 Empathy Research in SW A SW model/ definition of empathy must include empathic action. Gerdes & Segal 2009 Model proposed has 3 components Affective response (mirror neurons) Cognitive processing of affective response & others perspective Conscious decision-making to take empathic action

11 Social Work Motivation Altruism consistently emerges as a primary motivation of social work students (King 2011, p.690). Clinical social workers are, in the most basic sense guided by compassion for humanity and an altruistic desire to improve individual and societal conditions (Radley & Figley 2007).

12 BURN OUT Too often we focus on disorders, psychopathology, dysfunction we must balance these with a focus on altruism, compassion, [and] resilience, (Radley & Figley 2007)

13 Stress & Resilience Kinman & Grant 2012 In the previous five years, 20% of the U.K s 76,000 social workers had been signed off work for more than 20 consecutive days due to conditions such as stress or anxiety (The Observer, 2008) The time in post of a newly qualified social worker is approximately eight years, considerably less than people working in similar professions (Curtis et al., 2009) Adamson & Beddoe 2011 It s important to support and not extinguish altruism and hopefulness (p.112)

14 Personal Distress and Burn-out Thomas 2013 Results in this study suggest that it is the aspect of empathy labeled as personal distress which may result in harmful effects for practitioners. Well-regulated people, even when they experience intense emotions, are more likely to experience prosocial empathic concern and are less likely to experience personal distress. Thomas and Otis (2010) found mindfulness was associated with lower levels of compassion fatigue and burnout among clinical social workers, as well as higher levels of compassion satisfaction.

15 Compassion is Protective Empathy Empathic distress (self-focused) Emotion Regulation & Mindfulness Empathic concern/ Compassion (other-focused) Emotional exhaustion burn-out / compassion fatigue Compassion satisfaction Pro-social responses

16 Emotions & Mindfulness Howe (2008) The successful management of emotions is likely to underpin resilience in social care workers. Duer (2008) More than 20 years of empirical studies offers strong evidence that meditative and contemplative practices can aid in relieving the acute symptoms of compassion fatigue and burnout, including depression and anxiety (p.1)

17 Mindfulness & Emotion Regulation

18 Mindfulness in Social Work Social workers have recently begun to study the usefulness of mindfulness in practice and education. CARE program: Increased mindfulness & decreased stress (McGarrigle and Walsh, 2011) Students have a strong desire to learn & experience mindfulness meditation. They responded positively & felt it was relevant to personal development (Birnbaum and Birnbaum, 2009)

19 SOCIAL COGNITIVE NEUROSCIENCE

20 Compassion Research Klimecki, Singer et al 2012 "Importantly, in comparison to other techniques for increasing positive affect, compassion benefits both the person who experiences it (through strengthening positive affect) and the recipient of compassion (through fostering pro-social motivation). Results suggest that compassion training can be a powerful new method for enhancing positive affect in response to adverse situations.

21 Compassion Benefits Self and Others Kim et al 2009 Taking a compassionate attitude may enhance the activities of brain regions involved in the cognitive and experiential understanding of another s state and thereby enables deep understanding for others A compassionate attitude modulates the activities of the brain network that is known to be implicated in the prosocial/social approach motivation and the accompanied rewarding feeling.

22 Compassion Can be Trained Hutcherson et al 2008 (Stanford) Significant effects of loving- kindness meditation on both explicit and implicit positivity toward neutral strangers. Even a brief (7-min) exercise in cultivating positive regard was sufficient to induce changes. Some changes in implicit positivity were also observed toward the self, a finding in keeping with one of the goals of LKM Pace, Negi et al 2008 (Emory) Within meditation group, decreased reactivity to stress with increased meditation time Significant correlations between amount of practice and reduced stress induced immune/ behavioural responses.

23 Compassion Can be Trained Jazaieri et al 2012 The goals of this study were to examine whether compassion training would influence three specific orientations of compassion: compassion for others, compassion from others, and self-compassion. Compassion Cultivation Training resulted in significant improvement in all three orientations of compassion.

24 Compassion Can be Trained Hoffman et al 2011 Empirical evidence from the intervention literature suggests that elements of Loving Kindness Meditation and Compassion Meditation can be trained within a relatively short period of time. In sum, existing research studies suggest that LKM and CM are highly promising practices for improving positive affect and for reducing stress and negative affect such as anxiety and mood symptoms.

25 Meditation Increases Compassionate Response to Suffering Harvard Medical School Condon, Desbordes, et al That eight weeks of meditation resulted in such a large effect increasing the odds of acting to relieve another s pain by more than five times, is all the more striking given that it occurred in a social context whose features should attenuate such behaviour.

26 Compassion/ Empathy Training Emory University Stanford University CCARE Berkely University Harvard Medical School Paul Gilbert Compassion focused therapy Kristen Neff Self-compassion Joan Halifax End of life care Compassion and Empathy Conference- London

27 Cultivating Emotional Balance (CEB) Mind and Life Conferences - Buddhism and Science Dharamsala in 2000 Destructive Emotions Prof Paul Ekman & Dr Alan Wallace Psychological: Seven Universal Emotions (Fear, sadness, anger, surprise, disgust, contempt, happiness), and practical exercises designed to help participants become more aware of emotions as they arise in themselves and in others. Contemplative: Shamatha (Mindfulness) Vipassana (Insight) 4 Immeasurables (Kindness, Compassion, Equanimity & Empathic Joy)

28 CEB Research 83 female school teachers, nil psychiatric diagnosis, with live in partner, wait list control. Study published in peer reviewed journal Emotion (2012). Increased pro-social responses, including compassion, and decreased negative social responses. Increased ability to recognize facial expressions of emotion a critical component of compassion When presented with an image of a suffering individual, were more likely than controls to activate a semantic network related to compassion rather than disgust.

29 CEB The Four Balances Conative Balance Emotional Balance Attentional Balance Cognitive Balance

30 Participatory Action Research Participatory Action Research: A collaborative practice of research that aims to change the researchers themselves as well as the social world they inhabit, and aims to create circumstances in which people can search together collaboratively for more comprehensible, true, authentic, and morally right and appropriate ways of understanding and acting in the world (Kemmis & McTaggart, P.578)

31 Meditation

32 References: Australian Association of Social Workers. (2012). AASW: Australian Social Work Education and Accreditation Standards. Australian Association of Social Workers. Australian Association of Social Workers. (2010). AASW: Code of Ethics. Australian Association of Social Workers. Australian Association of Social Workers. (2008). AASW: Practice Standards for Mental Health Social Workers. Australian Association of Social Workers. Batson, C. D., Fultz, J., & Schoenrade, P. A. (1987). Distress and empathy: Two qualitatively distinct vicarious emotions with different motivational consequences. Journal of personality, 55(1), Birnbaum, L., & Birnbaum, A. (2008). Mindful social work: From theory to practice. Journal of Religion & Spirituality in Social Work: Social Thought, 27(1-2), Condon, P., Desbordes, G., Miller, W., DeSteno, D., Hospital, M. G., & DeSteno, D. Meditation increases compassionate responses to suffering. Psychological Science. Duerr, M., & Consulting, F. D. (2008). The use of meditation and mindfulness practices to support military care providers: a prospectus. Centre for Contemplative Mind in Society, Northhampton, MA. Gair, S. (2011). Creating spaces for critical reflection in social work education: learning from a classroom-based empathy project. Reflective Practice, 12(6), Gerdes, K. E., & Segal, E. A. (2009). A social work model of empathy. Advances in Social Work, 10(2),

33 References: Gerdes, K. E., Segal, E. A., & Lietz, C. A. (2010). Conceptualising and measuring empathy. British Journal of Social Work, 40(7), Gerdes, K. E., & Segal, E. (2011). Importance of empathy for social work practice: Integrating new science. Social work, 56(2), Gerdes, K. E., Segal, E. A., Jackson, K. F., & Mullins, J. L. (2011). Teaching empathy: A framework rooted in social cognitive neuroscience and social justice. Journal of social work education, 47(1), Hofmann, S. G., Grossman, P., & Hinton, D. E. (2011). Loving-kindness and compassion meditation: Potential for psychological interventions. Clinical psychology review, 31(7), Howe, D. (2008). The emotionally intelligent social worker. Palgrave Macmillan. Hutcherson, C. A., Seppala, E. M., & Gross, J. J. (2008). Loving-kindness meditation increases social connectedness. Emotion, 8(5), 720. Jazaieri, H., Jinpa, G. T., McGonigal, K., Rosenberg, E. L., Finkelstein, J., Simon-Thomas, E.,... & Goldin, P. R. (2012). Enhancing compassion: a randomized controlled trial of a compassion cultivation training program. Journal of Happiness Studies, Kemeny, M. E., Foltz, C., Cavanagh, J. F., Cullen, M., Giese-Davis, J., Jennings, P.,... & Ekman, P. (2012). Contemplative/emotion training reduces negative emotional behavior and promotes prosocial responses. Emotion, 12(2), 338. Kim, J. W., Kim, S. E., Kim, J. J., Jeong, B., Park, C. H., Son, A. R.,... & Ki, S. W. (2009). Compassionate attitude towards others suffering activates the mesolimbic neural system. Neuropsychologia, 47(10), King Jr, S. H. (2011). The structure of empathy in social work practice. Journal of Human Behavior in the Social Environment, 21(6),

34 References: Kinman, G., & Grant, L. (2011). Exploring stress resilience in trainee social workers: The role of emotional and social competencies. British Journal of Social Work, 41(2), Leiberg, S., Klimecki, O., & Singer, T. (2011). Short-term compassion training increases prosocial behavior in a newly developed prosocial game. PloS one, 6(3), e Lloyd, M., & Carson, A. (2011). Making compassion count: equal recognition and authentic involvement in mental health care. International Journal of Consumer Studies, 35(6), McGarrigle, T., & Walsh, C. A. (2011). Mindfulness, self-care, and wellness in social work: Effects of contemplative training. Journal of Religion & Spirituality in Social Work: Social Thought, 30(3), Pace, T. W., Negi, L. T., Adame, D. D., Cole, S. P., Sivilli, T. I., Brown, T. D.,... & Raison, C. L. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology, 34(1), Radey, M., & Figley, C. R. (2007). The social psychology of compassion. Clinical Social Work Journal, 35(3), Spandler, H., & Stickley, T. (2011). No hope without compassion: the importance of compassion in recoveryfocused mental health services. Journal of Mental Health, 20(6), Thomas, J. T. (2012). Does Personal Distress Mediate the Effect of Mindfulness on Professional Quality of Life?. Advances in Social Work, 13(3),