COST OF EMPATHYChild & Family Services Frontline Staff Workshop
Facilitators: Connie Miller & Jacquie Aitken Kish
Where do we fit ?PTSD
Post Traumatic Stress Disorder(D.S.M.,1980)
Rapid onset burnout & Gradual Burnout(Mitchell, 1975)
Grief
Vicarious Traumatization
(Pearlman,1990)
Burnout (Freudenberger, 1974)
Depression(D.S.M.)
STSDSecondary Traumatic
Stress Disorder (Figley,1982)
Compassion Fatigue (Joinson, 1992)
Background QuestionnaireBACKGROUND QUESTIONNAIRE
1. Age 25 - 30 ___ 40 - 45 _____ 55 - 60 _____
30 - 35 _____ 45 - 50 _____ 60 - 65 _____
35 - 40 _____ 50 -55 _____
2. Gender Male _____ Female _____
3. Number of years working with victims of trauma/abuse/ or individuals in crisis.
Frontline Supervisory
0 – 2 years __________ __________
2 – 5 years __________ __________
5 -10 years __________ __________
10 -15 years __________ __________
15 – 20 years __________ __________
20+ years __________ __________
4.Have you supported a colleague who presented burnout or trauma related to their work with victims of trauma/abuse?
Yes __________ No __________
On one occasion __________ 2 - 5 occasions _________
5 - 10 occasions __________ Over 10 occasions __________
5. Have you identified within yourself symptoms of stress that you believe are related to your work with victims of trauma/abuse/crisis? Yes __________ No __________ If yes, do you identify them arising from : (check as many as apply)
_____ an incident when my safety was at risk _____ a physical assault on self _____ a verbal attack or threat on self _____ an incident where I witnessed trauma to a client _____ dealing with a complete suicide of a client _____ Other _________________________________________ If yes, when you were experiencing the stress, did you feel supported by?
YES NO SOMETIMES Friends & Families ______ _______ ______ Colleague’s _______ _______ _______ Supervisor _______ _______ _______ The department _______ _______ _______
6. Have you received formal education regarding burnout/vicarious trauma?Yes _______ No _______
If yes, specify: _________________________________________________ _____________________________________________________________ _____________________________________________________________
Burnout: Can be described as an erosion of the soul, a feeling that regardless of what the person does, they cannot make a difference in their work place.
• This might be accompanied by feelings of hopelessness• A loss of motivation• A sense of mismatch between what you are capable of
and what is expected.
That’s why more people see burnout as being off purpose, not just overwhelmed.
Dr. Jane Simington, Phd, Taking Flight International
Life in BalanceAbility to
cope
stress stress
Self care stress
Crisis: When stress overwhelms one’s ability to cope
Ability to cope Stress
stress
stress
stress
Self care
coping
One event can Overwhelm
Major loss/critical
incident/assault
Shock, disbelief, denial
Daily stress
Life stress
STRESS
Stress can Build:Gradual Burnout/ Vicarious trauma/ Depression
Small issue
Small issue
Small issue
Small issue
Small issue
New issues/loss may open unresolved pain
MAJOR LOSS &/or Similar loss
Major pain/issue from the past
Sources of Stress
Personal Life
• Self capacities• Personal safety• Past experiences• Intimate relationships• Boundaries
Work Life
• Nature of the client• Nature of the work• Physical environment• Nature of the work
place• Context of the work
1. Chose client experiences that have stayed with you – could be fairly recent or in the past but not ongoing. (Chose a negative and positive experience.)
2. Share the experience with your group – including how you coped with the situation and what you learned.
3. The groups role is to listen and provide supportive feedback –support the speaker.
4. Monitor your reactions and then as a group, brainstorm what were helpful debriefing techniques
Exercise
Impact of Stress and Burnout
Cognitive
Emotional
Physical
Behavioral
Impact of Stress and Burnout
Cognitive: poor concentration memory problemspoor attention span slowed problem solvingdifficulty making decisions/calculations
Impact of Stress and Burnout
Cognitive: poor concentration memory problemspoor attention span slowed problem solvingDifficulty making decisions/calculations
Emotional: mood swings depressionanxiety, fear overwhelmed
Impact of Stress and Burnout
Cognitive: poor concentration memory problemspoor attention span slowed problem solvingDifficulty making decisions/calculations
Emotional: mood swings depressionanxiety, fear overwhelmed
Physical: muscle tremors chest paindifficulties breathing elevated blood pressure
Impact of Stress and Burnout
Cognitive: poor concentration memory problemspoor attention span slowed problem solvingDifficulty making decisions/calculations
Emotional: mood swings depressionanxiety, fear overwhelmed
Physical: muscle tremors chest paindifficulty breathing elevated blood
pressureBehavioral: withdrawn excessive silence
change in work habits easily frustratedsleep disturbances change in hygiene
Compassion Fatigue
•A condition characterized by a gradual lessening of compassion over time. Sufferers can exhibit symptoms including hopelessness, decrease in pleasure, and pervasive negative attitudes. Sufferers develop new feelings of incompetency and self doubt.
•It can have a detrimental effect on individuals both, personally and professionally.
Burnout (CHECK)
- 36 or less = extremely low risk- 37 - 50 = moderate risk- 51 – 75 = high risk- 76 - 85 = extremely high risk
Compassion Satisfaction (X)- 118 & above = extremely high potential- 100 – 117 = high potential- 82 – 99 = good potential- 64 – 81 = modest potential
Below 63 = low potential
Compassion Fatigue (CIRCLE)
- 26 or less = extremely low risk- 27 – 30 = low risk- 31 – 35 = moderate risk- 36 - 40 = high risk- 41 or more = extremely high risk
Compassion Satisfaction/Fatigue Test
Recovery ProcessDealing with
powerlessness & helplessness
Recognize the value of our
work
Reality confirmation
Placing blame where it belongs
Occupational hazard
Our Strength/ Recovery Process
Expressing thoughts &
feelings
Dispelling the minimization of the experience
Sharing the burdenSupervision/partnering
Breaking down isolation
control
• 0 10
responsibility
• 0 10
If you take responsibility for something you have no control over it will drive you nuts.
William F. Nelson
Recovery ProcessDealing with
powerlessness & helplessness
Recognize the value of our
work
Reality confirmation
Placing blame where it belongs
Occupational hazard
Our Strength/ Recovery Process
Expressing thoughts &
feelings
Dispelling the minimization of the experience
Sharing the burdenSupervision/partnering
Breaking down isolation
Ways of Coping
nameTake care of self
Finding Purpose/Passion
List the things that you do for fun or really enjoy. (parts of your job, recreation, family life)
Write down the people you admire and why.List the things that you do naturally without thinking. (eye for detail,
sense of humor, ability to focus)
Finding Purpose/Passion
List the things that you do for fun or really enjoy (pats of your job, recreation, family life)
Write down the names of people you admire and why. List the things that you do naturally without thinking about it (eye for
detail, sense of humor, ability to focus)
Listen to the Voice Inside to guide you to your true desires
Purpose
• Purpose is often seen for the future but try to find ways to start now:
• Have a side project close to your heart
• Try to introduce something reflecting your purpose in some aspect of work
• Try to express in the interaction with others
Prevention
• Increase self awareness/reflection• Engage social supports• Mobilize organizational supports• Engage in self care/self soothing
activities
Prevention
Remember
• Stress management techniques are useful before you are stressed or are in the early stages of stress. If you are severely stress such course are of little value.
• It the becomes a case of rearranging deck chairs on the Titanic.
• Stress management at this point is ineffective because it can make people feel worse. The whole premise of stress management is that you are still coping.
BORN TO LIVEAnn Mortifee
We were born to live, not just survive
Though the road be long and the river wide
Though the seasons change and the willows bend
Though some dreams break some others mend
Though we are born to give and born to take
To win and lose and to celebrate
We were born to know and born to muse
To unfold our hearts, take a chance to choose.
We were born to love, though we feel the thorn
When a ship sets sail to return no more.
Though we’re born closed and we feel pain
To chance it all and to love again
We were born to reach, to seek what’s true
To surrender all, to make each day new.
We were born to laugh and born to cry
To rejoice and grieve just to be alive.
We were born to hope and to know despair
And to stand alone when there’s no one there.
We were born to trust and to understand
That in every heart there’s an outstretched hand.
We were born to love, to be right or wrong,
To be false and true, to be weak and strong.
And to know to live, to break down the wall
And to know that life is to take it all.
Thank You!Questions Evaluations
Resources
The Theory of Positive Disintegration by Kazimierz Dabrowski.
Level 5 –Secondary Integration
Level 4 – Directed Multilevel Disintegration
Level 3 – Spontaneous Multilevel Disintegration
Level 2 – Unilevel Disintegration
Level 1 – Primary Integration