Newly Registered Professional Training - Resilience. Train the trainer day 26 th October 2016

Transcription

1 Newly Registered Professional Training - Resilience Train the trainer day 26 th October 2016

2 Schedule for today Introduction to the 3 hr training on resilience Go through part Break Go through part Break Go through part 3 and evaluation Answer questions Time to practice

3 3 hour resilience training A series of ppt and activities which aim to increase participant s knowledge of stress and resilience. Provides participants with the time, space, resources and support to reflect on how they are coping and if they could do things differently

4 3 hour resilience training Dr Laura Biggart School of Psychology Prof Kevin Daniels Norwich Business School Dr Patricia Harris Faculty of Medicine and Health Sciences

5 Success of the full day training 7 Pre-Post: General intervention outcomes Well-Being Self-Esteem Motivation Support Pre Post

6 Success of the full day training 6 Pre-Post: Specific intervention outcomes Emotional Intelligence Confidence to solve problems Pre Post Difficulty to regulate emotions

7 3 hour resilience training Learning outcomes 1) define what resilience is, introduce emotion and problem focused coping and identify areas of personal strengths and weaknesses (1 hour) 2) identify emotional challenges and introduce EI and how that supports resilience in interpersonal workplaces (1 hour) 3) introduce effective problem solving through 'stepping back and breaking down' and 'utilising support networks (30 minutes)

8 How the training sessions link Resilience = maintaining normal functioning despite stress Maintaining professionalism Maintaining effective communication Communication or a lack of can often be the cause of problems which result in stain Poor integration can reduce resilience as it hinders support networks, problem solving, wellbeing,

9 Outcomes for today 1) understand the background theory of the stress response, coping and resilience 2) observe and practice administrating the activities 3) discuss and prepare for feedback after each activity 4) opportunity to ask your own questions and discuss responses to FAQ

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12 What is resilience? Capability to withstand stress Resulting bend = strain Application of pressure = stress

13 Resilience in humans Psychological and physiological resilience Psychological resilience Emotional resilience What is resilience trying to achieve? How can it improve outcomes during times of stress?

14 Lazarus and Folkman 1984 Model Situation/event Primary appraisal Perceived threat Secondary appraisal No threat perceived Perceived INABILITY to cope Perceived ABILITY to cope Negative stress Positive stress No stress

15 Determinants of a positive primary appraisal Stress response can be triggered by any situation that is: Novel Unpredictable Uncontrollable Risk to self, others or ego

16 The physiological stress response Following Primary Appraisal Acute, stress response Fight, flight or freeze Sympathomedullary Pathway (SAM)

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18 The acute physiological response Physiological Symptoms driven by SAM Increased energy Increased heart rate Increased breathing rate

19 Lazarus and Folkman 1984 Model Situation/event Primary appraisal Perceived threat Secondary appraisal No threat perceived Perceived INABILITY to cope Perceived ABILITY to cope Negative stress Positive stress No stress

20 Sustained stress Longer term response Chronic stress Hypothalamus pituitary - adrenal axis (HPA)

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22 Chronic physiological response Physiological Symptoms driven by HPA axis Increased BP Muscle tension and pain Headaches Grinding teeth Restlessness Non-cardiac chest pains Sweating Feeling dizzy Breathlessness Dry mouth Fatigue

23 Why might the physiological response be unhelpful? Thank about: What situations causes you to feel stressed? In your groups discuss what causes you stress and find one stressor you all have in common. Which of the 4 categories does it fall into? Novel Unpredictable Uncontrollable Risk to self, others (incl. ego, reputation etc.)

24 Why is it a problem? Nowadays the stress response is activated by situations where the physiological response is not helpful Long term or frequent activation can be damaging Sustained HPA axis activation: cardiovascular damage, immune dysregulation, memory problems

25 Psychological response What is the psychological response? What symptoms of stress would be classified under the psychological response? Is it as damaging as the physiological response if it goes on too long?

26 Psychological response Cognitive Behavioural Emotional Reduced concentration Poor memory Difficulty thinking logically Constantly worrying Racing thoughts Imagining the worst Having temper outbursts Being irritable Drinking / smoking more On the go all the time Talking more or faster Changing your eating habits Feeling unsociable Being forgetful or clumsy Being unreasonable Feeling anxious Low self-esteem Low mood Frustrated Feeling overwhelmed Sense of loneliness

27 Back to the question What is resilience trying to achieve? How can resilience improve outcomes during times of stress? Resilience is the natural traits and developed skills that : Prevent unnecessary activation of the stress response Limit the intensity and duration of the stress response Managing our behavioural, emotional, cognitive and physiological responses to stressful situations Allow an individual to continue to function

28 It s not extraordinary Resilience results from a basic human adaptation (Masten, 2001) Even the most resilience individual is not immune to the normal symptoms of stress, but they are better able to manage their symptoms. Resilience does not mean invincibility, rather an ability to resist becoming overwhelmed to the point of extreme physical or psychological distress.

29 Areas of resilience Coping Varied strategies Situation appropriate Practice acceptance Awareness Of self and others Know limitations Know when to seek help Outlook Positive outlook Consider multiple interpretations Support network Build a strong network Use it appropriately Self care time, space and reward

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31 Adaptive or maladaptive In groups look at the case studies decide whether the strategy they have chosen is problem or emotion focused whether it is adaptive or maladaptive for that situation. What would have been your advice in the situation?

32 Case 1 Mr and Mrs Campbell have been sent several late notices for their mortgage payment. Mr Campbell is meant to deal with the bills but he knows there is not enough money in his account to pay the re-payment this month. He doesn t want his wife to find out that he has made a mistake in budgeting so decides to throw out the letters. He has found that by ignoring the letters and not thinking about the problem, he is able to carry on with his day without any side effects.

33 Case 2 Hollie Jones is 36 and has two young daughters. She has been diagnosed with breast cancer due to an abnormal BRCA 1 gene. Hollie is experiencing a range of emotions following her diagnosis including; thinking the worst and what would happen to her daughters if she was no longer able to care for them. What worries her the most is that she may have passed the gene onto her children. Hollie s mother is encouraging her to take her mind off things by organising lots of trips away. She is also trying to help Hollie to think positively about the situation because she has been diagnosed, the children will be entered into an early screening programme.

34 Case 3 Sarah owns a small company which provides local home care. In the past few months she has had a significant increase in the number of clients looking for morning and evening care and she feels guilty if she turns anyone down. To meet the demand Sarah is making the calls herself starting at 5am and finishing at 11pm. She is spending less and less time with the clients in order to fit everyone in and is waking and putting clients to bed at times that do not suit them. Sarah knows this isn t right but won t accept that she only has limited capacity and thinks it s better that she goes rather than asking her part-time staff, who have young families, to do extra hours.

35 Case 4 Darren is a qualified health professional, he has been working for the same hospital for 8 years and he has a family of 3 children under the age of 5. He loved his job and was happy in his position until quite recently. Due to sudden staff changes Darren was asked to temporally take on additional administration and management roles but this was 10 months ago and no replacement post has been advertised. He is struggling to keep up with the increased work load and spend time with his family with the result that he is constantly tired, is beginning to make mistakes and is starting to dread going to work. Darren decides to make an appointment with his senior manager to discuss his role and what he can reasonably be expected to do.

36 Dealing with feedback from the coping exercise Aim of the exercise is to recognise that maladaptive or adaptive is situation specific. Coping strategies can move between these categories and can start off in one category and over time move to the other as elements of the situation change Feeding back on what participants would do in that situation is only to demonstrate that there are lots of different approaches not one right answers

37 Areas of resilience Coping Varied strategies Situation appropriate Practice acceptance Awareness Of self and others Know limitations Know when to seek help Outlook Positive outlook Consider multiple interpretations Support network Build a strong network Use it appropriately Self care time, space and reward

38 Assess your resilience How would you rank yourself against these traits of resilience? Ability to accept reality Take an objective view, look at the bigger picture and accept your limitations and what you have control over Positive outlook Life is meaningful, confidence in your strengths and believe some good will come of the situation Creative and flexible thinking Consider alternative interpretations, imagine possibilities others don t see and be creative with your resources to apply coping to the unfamiliar situations Self-awareness Recognise and understand why you are feeling a certain way, know how to manage and change your emotional response and therefore the physiological response

39 Break Give participants a 15 min break at this point in the 3 hr training.

40 FAQ from part 1 Adaptive vs maladaptive classification How ignoring the problem sometimes helps so can also be adaptive in some situations Rarely get asked more about the biology but some people are interested in the mechanism by which the physiological response alters concentration and immune response (depends on the strength and duration of the response)

41 Favourite questions You said the stress response evolved but that it s not that helpful for the stress we experience now will the response keep evolving and become helpful again? Can you be genetically more resilient?

42 Morning break 26 th Oct

43 Part 2 Emotional Intelligence LO for part 2: What is EI Does EI matter at work? (are emotions not left at the door?) Can EI be improved?

44 What is EI? 1. Understanding emotions INTRA - personal factors INTER - personal factors 3. Perceiving emotions in others 5. Influencing emotions in others 2. Recognising emotions in self 4. Managing emotions in self

45 What are emotions? Specific reactions to an event Fairly short or fleeting Where they are long lasting these become moods Complex psychological state a subjective experience relating to something or someone which is real or imagined inform us of a physiological response (also cause) driving force behind many behavioural or expressive responses They can come in combinations and blends often making them difficult to deal with

46 Using knowledge of emotions to understand individual differences in stress appraisal and coping at work Emotions inform these appraisals Situation/event Primary appraisal Perceived threat Perceived INABILITY to cope Secondary appraisal Emotional Intelligence helpful for coping Perceived ABILITY to cope No threat perceived Negative stress Positive stress No stress October 13, 2016 Lazarus and Folkman 1984

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48 Why should we care about emotions at work? We spend 1/3 of our waking hours at work Modern workplaces are interpersonal and tax our emotional abilities Emotional Labour Emotions affect working relationships Emotions affect performance at work

49 What is EI? 1. Understanding emotions INTRA - personal factors INTER - personal factors 3. Perceiving emotions in others 5. Influencing emotions in others 2. Recognising emotions in self 4. Managing emotions in self

50 1. Understanding emotions Understanding what emotions are Knowing how emotions work together Mix of contradictory emotions (e.g. sad/relief/guilt) Knowledge of how emotion and context work together Tatiana was annoyed that a co-worker took credit for a project she had led, and when he did it again she felt a) Anger b) Annoyance c) Frustration d) Startled e) Depression Those who are better at understanding emotions, and reconciling blends can be thought of as more Emotionally Intelligent and more resilient

51 2. Recognising Emotions in Self - Emotional Physiological responses

52 3. Recognising emotions in others What emotion is this?

53 Compassion

54 What are you finding emotionally challenging at work?

55 What are you finding emotionally challenging at work? What aspects of the role do you find emotionally challenging? What emotions do you feel when dealing with these challenges? How do you manage your feelings? What parts of the role do you find rewarding?

56 Feedback After emotional challenges at work activity ask: what did you think about that task? acknowledge the # emotional challenges realise it s not just you recognise some good and bad habits for managing feelings it s not all bad *Look at examples produced by others

57 Frequently made statements I don t get very stressed so I don t really see how this will be helpful Talking about stress and all the things I find emotional at work is stressful so I d rather not take part I think sometimes you just have to get on with in and not dig too much into emotions and thing

58 4. Managing emotions is the ability to: Believe we can improve/modify feelings Use preventative and responsive strategies to modify feelings Evaluate effectiveness of strategies Using judgement, not impulse 58

59 Preventative strategies - Thinking ahead Responsive strategies How we react Select situation Deciding to work somewhere away from noisy office to get report done Self - talk Be conscious of the voice inside our head. Try to reduce negative I can t to more positive I could try. Open up possibilities. Avoid rumination on the negative Modify situation Change meeting agenda to end with positive steps that can be taken Modify mood See high energy friends if feeling lethargic Reappraise situation how else could you interpret situation (more positively)? A colleague hasn t returned call of information. You might feel frustrated, disappointed with them and be irritable with them. You could interpret situation negatively e.g. I m not important enough or they don t respect me or you could consider alternative explanations which help change how you feel e.g. they re really busy, something may have come up Physical Learn relaxation techniques Take a walk, Incorporate regular exercise Eat regularly and well Behavioural Behave in a way which will improve situation and how you feel. Start a conversation with someone you ve been ignoring because of a perceived insult to you. Social support Talk to trusted friends, family, colleagues about problems Distraction (NB short term strategy) Do something different to take your mind off what s troubling you 59

60 5. Managing others emotions What strategies have you used to manage others emotions? Emotion modelling is one of the most successful methods this may be mediated through behaviour modelling T6jNI10 From 2minutes 10sec

61 Another reason EI is important for resilience? Wellbeing And earn more money: Momm et al., 2014 October 13, 2016 Mikolajczak 2014

62 End of part 2 Opportunity to give participants a quick break if there is time Answer any questions that arose from part 2 Part 3 will take 30 minutes

63 Lunch break 26 th Oct

64 Problem solver a characteristic of resilient individuals Learning objectives for part 3 Effective problem solving Long term view Time and space Right person Review, learn and share

65 Models for problem solving F9I

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67 1. Taking a long term view to find long term solutions Long Term View What recurring problems do you have that get in the way at work? Review, Learn & Share Overcoming Problems and Challenges Time & Space In your groups come up with one problem that you want to tackle. Right Person Use your emotional challenges list to help.

68 Break down a problem The 5 Whys? Take a problem 1. Ask why? it happens 2. Ask why? the answer you gave in 1. happens 3. Ask why? the answer you gave in 2. happens Carry on until you ve asked why? 5 times By fifth why? we get to underlying causes Avoid assumptions May need more information to answer why?

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70 2. Making the Time and Space Long Term View Where / how can you create time to problem solve? Review, Learn & Share Overcoming Problems and Challenges Time & Space Right Person

71 3. Finding the Right Person Who do you go to for Help with problems? General work advice? Social chat? Long Term View A mix of work and social chat is healthiest to maintain positive mood. Review, Learn & Share Overcoming Problems and Challenges Time & Space A person could be the problem! They may need to be included to find a solution. Right Person

72 Measure your support network Use either the table or bubble diagram in the workbook 1. Who do you go to under each category? (Advice / Support / Chat / Sharing solutions) 2. Think about the problem you are working on or a regular problem that is personal to you - who would you like to go to?

73 4. Reviewing, Learning and Sharing the Learning Find the best solution by reviewing if it worked. Long Term View If it s a problem for you it s likely a problem for others too. Review Learn Share Overcoming Problems and Challenges Time & Space Do you review and share solutions with others? Right Person

74 Personal plan Complete the personal planning template in the workbook Will you now be looking out for physical and psychological signs of stress? Will you review any of the ways in which you cope with stressful situations? maladaptive / adaptive How are you going practice your new EI knowledge and skills to help you at work (and at home)? What problem are you going to apply the steps of the problem solving model to? Who is in your social network who else do you need to add?

75 Close 3 hr training Refer to the findings of our project with health professionals at JPUH which showed those who took part in training on the stress response, EI and PS were: more motivated, more confident in their PS, felt more supported, had increased wellbeing, self-esteem and EI But warn that it s something that we need to keep on top of and that self-care plays a massive part

76 Evaluation Pre-training administered by trainer Create unique ID to provide consent Complete Q aire Return to Patricia.Harris@uea.ac.uk or Patricia Harris, Queens Building, University of East Anglia, Norwich, NR4 7TJ Post-training sent by UEA to participants via 1 month 3 months

77 Any questions?