Trauma Informed Excellence. Pre Assessment! Dangers in Helping Traumatized Patients & Self Care Strategies. Objectives. Tilting the Balance 5/1/2016

Transcription

1 Trauma Informed Excellence Five Modules to Understand Trauma and How to Support Our Patients Dangers in Helping Traumatized Patients & Self Care Strategies The Fourth of Five Modules 4 Dangers in Helping Traumatized Patients & Self care Strategies Objectives Pre Assessment! Section 1: Helping Fatigue Identify the interplay between Stress, Intensifiers & Burnout Define Compassion Fatigue, Vicarious Trauma & Secondary Trauma Recognize the four Stages of Burnout Section 2: Helping Satisfaction/Building Robustness Identify techniques to insulate self from vicarious trauma, secondary trauma, and compassion fatigue Learn strategies to improve quality of work and to enhance overall health Tilting the Balance Section 1: Helping Fatigue Is the life you re living worth the price you re paying to live it? Tony Schwartz 1

2 Small Group Activity What are some of your causes of helping fatigue? What negative outcomes have you experienced when you were feeling helping burnt out? Helping Fatigue Stress A biological reaction to changes in the environment that impacts a person s robustness (how full is your cup?) A personal reaction to changes Doesn t effect everyone the same o Past experience o Expectations o Current robustness state and level Impacted by level of intensity Helping Fatigue Stress Intensifiers Helping Fatigue Trauma Determines how quickly stress fills our cup Importance: If something is important, it can cause more stress Duration: The longer a stressor lasts, the more impact it has Uncertainty: The brain likes to predict, so uncertainty causes stress Empathetic Intensity Compassion Fatigue Secondary Trauma Vicarious Trauma Helping Fatigue Empathetic Intensity An ability to understand another s frame of reference and the conviction that it is worthwhile to do so. The transfer of emotions and pain from a traumatized patient to an empathetic helper Helping Fatigue Compassion Fatigue Compassion fatigue: when empathetic intensity overwhelms a helper s robustness Gradual filling of your cup with patients traumatic stories and life experiences Often present with burnout Miller & Rollick,

3 Helping Fatigue Vicarious Trauma Vicarious Trauma: witnessing a patient s traumatic experience and the resulting empathetic intensity Cost of being in crisis with someone Intensity Monster: Duration, Uncertainty & Importance Helping Fatigue Secondary Trauma Secondary Trauma: when empathetic intensity triggers a powerful countertransference reaction that overwhelms the helper s capacity Something about the patient s trauma connects with something in the helper s personality or past experience The result is that trauma is passed from patient to helper in a very real way Bloom & Farragher, 2011 Wilson and Lindy, 1994 Helping Fatigue Burnout Four Stages of Burnout Accumulated stress overwhelms our robustness Stress builds upon stress 1. Exhaustion Feel tired Low energy Small tasks seem huge Many warning signs along the way Happens over time Maslach & Leiter, 1997 Four Stages of Burnout Four Stages of Burnout 2. Shame & Doubt Stress affects the quality of our work Leads to self doubt Anxiety 3. Cynicism & Callousness Self doubt, exhaustion, anxiety, and shame trigger defensive reactions Blame others Maslach & Leiter, 1997 Maslach & Leiter,

4 Four Stages of Burnout Impacts of Stress, Trauma & Burnout Social 4. Failure, Helplessness & Crisis Personal life and work life are both affected severely Coping systems have been overwhelmed Crisis Maslach & Leiter, 1997 Section 2: Helping Satisfaction & Building Robustness Small Group Activity What are some of your causes of helping satisfaction? What drives your passion for the work you do? A calling to serve Passion Connected to our own personality Can be eclipsed by helping fatigue Important: Always keep your passion in the front of your mind The Act of Helping Dance of change and healing A balance of extremes Strategic focus on accomplishments 4

5 Self Care Basis of emotional, cognitive & social functioning Goal: Increase energy, mental processes, overall health Sleep Exercise Diet Lack of Sleep vs. Drunkenness Lack of sleep = Weight Gain, Type 2 Diabetes, Early Death Social Social Sleep Exercise Diet Removes cortisol from our cups Improves cognitive and emotional functioning Sleep Exercise Diet Love hate relationship Fuel for the brain Social Social Social Self Care The helpers ability to bring their best emotional, cognitive and social self to work Goal: Maximize capacity of the brain and mind Mind Social Mindfulness Positive Mindset Brain Power Observing and attending to perceptions, thoughts, and feelings Nonjudgmental of experience Labeling Non reactivity to inner experience Acting with awareness 5

6 Mindfulness Hope, empathy, compassion, life satisfaction, joy, and good moods Ability to regulate emotional responses and attention Quality of sleep Ability to quit or reduce smoking, binge eating, and substance abuse Immune functioning and wellbeing for those living with chronic diseases Stress Anxiety Depression Anger Mind Mindfulness Positive Mindset Brain Power Flow of positive energy connected to deeper meaning Realistic optimism Social Davis, 2012; Siegel 2010; Rock, 2009; Davidson, Kabat Zinn, Schumacher, Rosenkranz, Muller et al., 2003 Bloom & Farragher, 2011; Achor, 2008 Positive Mindset Serotonin, good mood Learning capacity Thinking, problem solving, creativity Productiveness Overall health Stress Social isolation Hopelessness Mind Mindfulness Positive Mindset Brain Power Increase brain power Disconnect Limit distractions Social Davis, 2012; Siegel 2010; Rock, 2009; Davidson, Kabat Zinn, Schumacher, Rosenkranz, Muller et al., 2003 Bloom & Farragher, 2011; Achor, 2008 Increase Brain Power Disconnect Take breaks every 90 to 120 minutes Take vacation Limit communication Productivity Quality of Services Overall Happiness Inefficiencies Burnout Limit distractions Multitasking Remove distractions Social Self Care Ability to utilize positive interactions to overcome empathetic intensity and helping fatigue Goal: Surround one s self with positive social interactions Rock,

7 Social Relationships & Robustness Power of social networks Increased robustness capacity Decreased stress and trauma levels The power of YOU Long term health Regulation of emotional states Overall well being Stress Trauma Worry Social Relationships & Robustness Role of Co Workers Christakis & Fowler, 2009 Christakis & Fowler, 2009 Social Role of Co Workers Co workers as social network Impact on each other s physical and emotional health Supporting each other Job performance Sense of purpose Recovery from setbacks Emotional, intellectual and physical resources Mental health and emotional issues Illness and absenteeism Stress Social Relationships & Robustness Role of Co Workers Christakis & Fowler, 2009 Christakis & Fowler, 2009 Tilting the Balance Towards Helping Satisfaction Quick Review of Objectives Section 1: Helping Fatigue Identify the interplay between Stress, Intensifiers & Burnout Define Compassion Fatigue, Vicarious Trauma & Secondary Trauma Recognize the four Stages of Burnout Section 2: Helping Satisfaction/Building Robustness Identify techniques to insulate self from vicarious trauma, secondary trauma, and compassion fatigue Learn strategies to improve quality of work and to enhance overall health 7

8 THANK YOU! Any questions? Please complete & turn in the Post Assessment Next month s presentation 5 Creating a Trauma Informed Clinic 8