Supporting Staff in working with Families in Trauma• Investigating a vicious abuse/neglect report • Frequent/chronic exposure to emotional and detailed accounts by children of

Minnesota Association for Children’s Mental Health

(MACMH) 2016

Supporting Staffin working with Families in Trauma

Learning Objectives

Participants will:

• Identify the different stress disorders associated

with working in families with trauma histories;

• Distinguish burnout and secondary traumatic

stress; and

• Practice strategies associated with preventing

stress

Introductions

• Small Group Exercise

What it is Not

• PTSD

• Bad Day

• Inability to see our impact

• Personal issues

• Secondary trauma is not burnout.

• Burnout is caused by increased workload and institutional stress

–Happens over time

–Time off or a change can remove or reduce it

What it is Not, cont.

• Vicarious trauma

• Compassion fatigue

• Secondary trauma

• Secondary victimization

Trauma by any other name…

What is Secondary Traumatic Stress?

• Exposed indirectly to trauma through hearing about

the firsthand trauma experiences of others

• A cumulative response to working with many trauma

survivors over an extended period of time,

• Or it may result from reactions to a particular client’s

traumatic experience.

Causes of Secondary Traumatic Stress• Facing the death of a child or adult family member on the worker’s

caseload

• Investigating a vicious abuse/neglect report

• Frequent/chronic exposure to emotional and detailed accounts by

children of traumatic events

• Photographic images of horrific injuries or scenes of a recent serious

injury or death

• Continuing work with families in which serious maltreatment,

domestic violence, or sexual abuse is occurring

• Helping support grieving family members following a child abuse

death, including siblings of a deceased child.

Causes of Secondary Traumatic Stress• Exposed to traumatic or life threatening events of

their own

• Intense verbal or physical assault by clients or

community members

STS is exacerbated by:

• Feelings of professional isolation,

• Frequent contact with traumatized people

• Severity of the traumatic material

– direct contact with victims,

– exposure to graphic accounts, stories, photos, and

things associated with extremely stressful events.

• Dealing with the pain of children

Symptoms of STS

• Inability to face complexity

• Avoidance of clients, inability to listen to clients

• Increased fatigue or illness,

• Social withdrawal,

• Reduced productivity,

• Feelings of hopelessness,

• Despair

Symptoms of STS, cont.

• Nightmares,

• Feelings of re-experiencing of the event, having

unwanted thoughts or images of traumatic events,

• Anxiety,

• Excess vigilance,

• Avoidance of people or activities, or

• Persistent anger and sadness

• Changes in feelings of safety,

• Increased cynicism, and

• Disconnection from coworkers and/or loved ones

• Managing boundaries,

• Dealing with their emotions

• Have anxiety for their own children and irritability

toward their colleagues and family.

Symptoms of STS, cont.

How STS affects workplace

• Higher rates of physical illness,

• Great absenteeism,

• Higher turnover,

• Lower morale, and

• Lower productivity.

Risk Factors• High caseload demands,

• A personal history of trauma,

• Limited access to supervision,

• Lack of a supportive work environment, and/or

• Lack of a supportive social network.

Prevention through Professional Strategies• Psychoeducation,

• Balanced caseloads,

• Accessible supervision,

• Planned assignment rotation,

• Access to peers,

• Continuing education,

• Access to new information

Prevention through Agency Strategies• Sufficient leave time,

• Safe physical space,

• Good supervision,

• Destigmatize trauma reactions through

organizational recognition or acknowledgement,

• Promotes timely mental health support, and

• Access to employee assistance program

Prevention through Personal Strategies

• Respecting your limits,

• Taking time for self-care,

• Teaming,

• Venting v. Fomenting, and

• Be wary of volunteering in a similar type of work

Personal Strategies

Reflective Supervision

• Stepping back from work

• Emotional content of the work

• Professional’s responses as they affect interactions

with clients

• Safety, calmness, and support

• Learning environment

• Not therapy

Protective factors

• Self-nurturing

• Seeking connection

• Social support network

• Outside interests

Interventions

• Strategies to evaluate secondary stress

• Cognitive behavioral interventions

• Mindfulness training

• Reflective supervision

• Caseload adjustment

• Informal gatherings following crisis events (to allow for voluntary, spontaneous discussions)

• Change in job assignment or work group

• Referrals to Employee Assistance Programs or outside agencies

Resources and References

• National Child Traumatic Stress Network

– www.nctsn.org

Contact Information

• Mary Black

– [email protected]

• Ann Gaasch

– [email protected]