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