COMPASSION FATIGUE ART ROMERO, MA, LPCC

Transcription

1 COMPASSION FATIGUE BY ART ROMERO, MA, LPCC

2 HELPING TILL IT HURTS! Mental Health Professionals tend to work from a base of compassion and empathy. Remember your first client? Remember the first client that stayed sober or successfully completed treatment? Remember how it felt?

3 COMPASSION SATISFACTION! To know that you are making a difference in someone s life, can be very rewarding. To be presented an award, or some kind of recognition for your work as a helping professional, can be very rewarding. To know that you are making a difference in your community can be very rewarding. All of these examples give us Compassion Satisfaction

4 COMPASSION SATISFACTION! The sense of reward! To have a client stabilize and progress in their recovery to a point of some success in their life, can be very rewarding. To help a family work through the reunification process, can be very rewarding. To develop a sense of competence as a helping professional can be very rewarding. To be recognized for your work by colleagues, can be very rewarding.

5 COMPASSION SATISFACTION Mental Health Professionals tend to work from a place of compassion and empathy. Having compassion/empathy can open the door to either feeling good about the progress of a client (satisfaction) or disappointment when a client fails or relapses, etc. or even worse commits suicide or dies from their addiction.

6 RESPONSIBILITY It is only human to have empathy and be affected by the pain of our clients. It can also feel that we are responsible to make things right What happens when we don t make things right? Most times we can manage to not take on this responsibility, however are there some cases where we do let it seep in? How about those of us that are over-achievers and take responsibility very serious?

7 VICARIOUS TRAUMA COMPASSION FATIGUE HELPING TILL IT HURTS? A Multimethod Study of Compassion Fatigue, Burnout, and Self-Care in the Clinicians Working with Trauma Survivors By: Kyle D. Killian, an associate professor in the Faculty of Health, and Researcher at the Centre for Refugee Studies, at York University, Toronto, Ontario, Canada It has become increasingly evident that the psychological effects of traumatic events, such as childhood sexual abuse, domestic violence, catastrophes, war, and terrorism, reach beyond those directly affected (Bride, 2007). This is an important area of investigation because healthy, psychologically present, and committed professionals are in a better position to offer assistance to trauma survivors than those providers who suffer from symptoms of compassion fatigue and burnout.

8 REVIEW OF THE LITERATURE The review suggests that helping professionals are regularly in contact with trauma survivors, and it makes sense that listening to traumatic case material tough stuff (e.g., that especially severe child sexual abuse case file making the rounds at an agency, a returning veteran who lost a leg and several of his or her friends, a survivor s detailed account of a sexual assault) for 30 to 40 hours a week or longer could lead to acute distress. Repeated and frequent exposure to persons suffering from posttraumatic stress symptoms can result in secondary or vicarious traumatization, leading to symptoms of PTSD Vicarious or secondary traumatization is a process by which a professional s inner experience is negatively transformed through empathic engagement with clients trauma material (Cunningham, 1999; McCann & Pearlman, 1990; Pearlman & Maclan, 1995). Vicarious trauma is also referred to as compassion fatigue.

9 SATISFACTION, FATIGUE, BURNOUT! Compassion Satisfaction = pleasure or happiness Compassion Fatigue = dwells in the neighborhood of fear and anxiety Burnout = emotional exhaustion and depersonalization, lack of self-efficacy The process for where a person can go from Compassion Satisfaction to Compassion Fatigue to Burnout can take a few months or several years. Repeated and frequent exposure to persons suffering from PTSD symptoms can speed up the process. What are some other factors?

10 BURNOUT AMONG CORRECTIONAL PROFESSIONALS Predictors of Burnout Among Correctional Mental Health Professionals By Deanna B. Gallavan (Dept. of Educational Psychology, University of Oklahoma; Jody L. Newman (Dept. of Educational Psychology, University of Oklahoma) Because deinstitutionalization policies of the 1950s required the closure of state mental institutions and the release of mentally ill individuals, there are now more individuals with mental illness in jails or prisons than there are in the remaining state mental hospitals (Fagan & Augustin, 2011)

11 BURNOUT AMONG CORRECTIONAL PROFESSIONALS In fact, prisons are now call The New Asylums. What does this mean? This means that all professionals such as : Mental Health Counselors, Nurses, Doctors, Correctional Officers, Probation Officers, etc. are charged with attending to those with serious psychological needs. It seems likely that professionals working in correctional settings are at risk for burnout. What adds to the risks is the high case loads, due to the high volume of inmates and probationers. The Professional is not allotted enough time in a day to accomplish individual goals and this can lead to feelings of low personal control, a known correlate to burnout. What adds to this concern is inmates having co-occurring substance abuse disorders; multiple medical problems, and legal difficulties resulting in transient lifestyle, financial instability, and high-risk behaviors.

12 IT CATCHES UP WITH US! Compassion Fatigue happens when we accumulate and carry the stories of trauma including images, sounds, resonant details we have heard, which then come to inform our worldview. It s a proven fact that we hold on to trauma. How can somebody who s holding so much trauma be of service to someone else if they re full up? You ve got to empty the glass -Mariska Hargitay Lets examine five categories of symptoms related to Compassion Fatigue

13 COMPASSION FATIGUE Exhaustion and physical ailments: Constantly feeling tired, even after having time to rest Physical tension in the body when its not needed, i.e. sitting at your desk or on your commute home Physical pain throughout the day such as headaches, back pain and wrist pain that you push through Difficulty falling asleep or excessive sleep Falling sick the moment you are able to rest, such as on a vacation

14 COMPASSION FATIGUE Emotional shifts: Hypersensitivity to emotionally charged material Feeling disconnected from your emotions and/or your body Guilt for having more resources & opportunities than those you serve Feeling like no matter how much you give, it will never be enough Feeling helpless or hopeless toward the future Increased levels of anger irritability, resentment or cynicism

15 COMPASSION FATIGUE Thought patterns: Difficulty in seeing multiple perspectives or new solutions Jumping to conclusions, rigid thinking, or difficulty being thoughtful and deliberate Questioning is any of this effective? Am I making any difference? Minimizing the suffering of others in comparison to the most severe incidents or situations Intrusive thoughts and imagery related to the traumatic material you have heard/seen

16 COMPASSION FATIGUE Behavioral shifts: Absenteeism and attrition Avoidance of work, relationships, responsibilities Dread of activities that used to be positive or neutral Using behaviors to escape (eating, alcohol, drugs, caffeine, TV, shopping work, gambling)

17 COMPASSION FATIGUE Relationship changes: No separation of personal and professional time, being the helper in every relationship Viewing other people as less important who are involved in your same field Difficulty relating to other peoples day to day experiences without comparing them to those you serve or yourself Absence of a personal life that is not connected to your work Seeing danger everywhere and hypervigilance to the safety of those you care about Sense of persecution or martyrdom-only interacting with people who are in your same field or can relate to your experience

18 BURNOUT Compassion Satisfaction Compassion Fatigue Areas of Worklife BURNOUT Four factors that place mental health professionals working with mental health clients with trauma hx at higher risk for CF are (a) being empathic (b) having a history of trauma (c) having unresolved trauma and (d) assisting in events where children are involved (Baird & Kracen, 2006; Figley, 2001)

19 AREAS OF WORKLIFE Burnout is associated with feelings of hopelessness and difficulties in dealing with work or in doing your job effectively (Stamm, 2009). The work life environment and the client (or the person helped) all have a role to play. Frontline Mental Health Professionals who experience a higher degree of CS in their work life, would also experience more positive work environment. Work life conditions play a role in both CS and CF (Killian (2008). The study by Susan L. Ray, Carol Wong, Dawn White, and Kimberly Heaslip, specifically found that higher levels of CS, lower levels of CF, and increased person-job match in the six areas of work life predicted lower burnout in FMHPs. The six areas of Work Life: workload; control; reward; community; values; fairness.

20 THE ROAD TO BURNOUT! Every day is a bad day. Caring about your work or home life seems like a total waste of energy You re exhausted all the time The majority of your day is spent on tasks you find either mind numbingly dull or overwhelming You feel like nothing you do makes a difference or is appreciated The negative effects of burnout spill over into every area of life including your home and social life. (Mike s story..) HelpGuide.ORG

21 THE THREE R APPROACH Recognize watch for the warning signs of burnout Reverse Undo the damage by managing stress and seeking support Resilience Build your resilience to stress by taking care of your physical and emotional health Now let s take a Self-Test to see where we are with Compassion Fatigue!

22 PREVENTING BURNOUT Start the day with a relaxing ritual (suggestions from the audience) Adopt healthy eating, exercising, and sleeping habits (suggestions from the audience) Set boundaries don t overextend yourself. Learn to say no. Remember saying no allows you to say yes to the things that you truly want to do. Take a daily break from technology set a time daily to disconnect. Nourish your creative side creativity is a powerful antidote to burnout. Learn how to manage stress this can help you regain your balance.

23 BURNOUT RECOVERY STRATEGIES Slow down when you have reached the end stage of burnout, adjusting your attitude or looking after your health isn t going to solve the problem. You need to force yourself to slow down or take a break. Get Support turn to your loved ones for support. (suggestions from the audience) Reevaluate your goals and priorities take time to think about your hopes, goals, and dreams. Are you neglecting something that is truly important to you?

24 COPING WITH JOB BURNOUT The most effective way to combat job burnout is to quit doing what you re doing and do something else, whether that means changing jobs or changing careers. But if that isn t an option for you, there are still things you can do. Actively address problems take a proactive rather than a passive approach to issues at work, including stress at work. You will feel less helpless. Clarify your job description ask for an updated description of your job duties and responsibilities. Point out things that you are expected to do that are not in your job description/duties. Ask for new duties ask for new duties, or change to another department. Take time off take a leave of absence or vacation anything to remove yourself from the situation.

25 SELF-CARE Self-care is essential for those of us that work with victims of trauma. Honoring self-care takes commitment and needs to be a priority. For some journaling can be a healthy way to process the day. Cooking a healthy meal. Relax after eating! Meditation (in a quiet place away from work) Yoga or going for a run, exercising, join a softball team or bowling team, etc. Therapy, join a support group, book club..

26 LET S PRACTICE SELF-CARE!