Empathy Fatigue: Dealing Effectively with the Stress and Grief Reactions of Extraordinary Stressful...

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Transcript of Empathy Fatigue: Dealing Effectively with the Stress and Grief Reactions of Extraordinary Stressful...

  • Slide 1
  • Empathy Fatigue: Dealing Effectively with the Stress and Grief Reactions of Extraordinary Stressful and Traumatic Events Mark A. Stebnicki, Ph.D., LPC, CRC, CCM Professor, Dept. of Rehab Studies East Carolina University www.ecu.edu/rehb
  • Slide 2
  • Empathy Fatigue: Healing the Mind, Body, and Spirit of Professional Counselors (Springer Publishing -2008) ~~~~~~~~~~~~~~~~~~~~~~~~ Personal Testimonials of Persons Experience of Empathy Fatigue
  • Slide 3
  • Purpose and Intent Identify & Recognize Critical Pathways to Empathy Fatigue (EF) and other professional fatigue syndromes. Describe Cumulative effects and Impact on the professional counselor which leads to the deterioration of the counselors empathic engagement with their clients. Provide Self-care Strategies for pre- professionals, counselor educators and supervisors that cultivate healthy coping and resiliency.
  • Slide 4
  • A Consciousness Shift in the Counseling and Allied Helping Professions September 11, 2001 (2,996 deaths) War in Afghanistan & Iraq (4,493 U.S. Soldiers; 88,456 Iraqi Civilian deaths +) Tsunami December 26 th 2004 (275,000 deaths in 11 countries Hurricane Katrina 2005 (70 deaths +) Child Deaths by intentional-unintentional gun violence (3,024yr) School deaths due to violence (92-98 171; 99-08 250) Cumulative AIDS-related deaths in U.S (through 2002 501,669d); Ethiopia (1.8 mil predicted by 08)
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  • Healthy Occupational Outlook for Counselors Fire Flood Hurricanes/Tornados Ice storms Plane crashes Volcanoes Earthquakes Epidemics Workplace violence Traumatic injury in the workplace School shootings Bioterrorism Transportation Accidents Civil Unrest 2 nd Depression
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  • A Constant State of Disaster Preparedness: Crisis Response Teams ARC/State Disaster MH EMS/IC-EM Law/Fire Public Health DSS School Counselors CISM Teams MH/LME EAPs Baptist Men Salvation Army United Way FEMA National Guard/Military Insurance Adjustors Media Airline Industry Banks/Financial Institutions
  • Slide 7
  • Empathy Fatigue (EF) A dynamic state of psychological, emotional, social, physical, occupational, and spiritual exhaustion that occurs on a continuum, resulting from the helpers own wounds that are continually revisited by their clients life-stories of stress, chronic illness, mental/physical disability, trauma, grief, and loss.
  • Slide 8
  • EF-The Wounded Healer Experience Traditional Native American teachings each time you heal someone you give away a piece of yourself until at some point you require healing. The wounded healer phenomenon has been noted throughout the history of counseling, psychology, and through spiritual leaders (Jung Nouwen, Rogers, Dali Lama) Journey to become a counselor, healer, or Shaman comes with the understanding that there is a cost to M-B-S.
  • Slide 9
  • EF- Both Same and Different as Other Counselor Impairments Countertransference (Ones Emotional Scrapbook): (Freud) unconscious absorption of the clients issues (Modern) symbolic experience of emotional self button-pushing; Burnout : - Classical (Freudenberger, 1974): a state of physical, emotional, and mental exhaustion; a negative shift in the way professionals view people they serve. - Contemporary (Maslach, [MBI]1982; 2003): 3 Factors- cumulative emotional exhaustion (EE), depersonalizaiton (DP), feelings of a lack or reduced personal accomplishment (PA) Consequences: a loss of compassion, genuineness, and concern for the client/consumer.
  • Slide 10
  • Comparing and Contrasting EF CCCCompassion Fatigue (CF): - Nursing Profession (Joinson, 1992): a special type of burnout experienced by those working in high stress or high touch professions (trauma, loss of life). - Evolving Construct (Figley 1995; 2002; Stamm, et al.) An acute stress reaction or unhealthy form of countertransference results from a state of emotional, mental, and physical exhaustion. CF is both same and different BUT CF is acute-BO is not. - Secondary Traumatic Stress (STS) Same as PTSD!
  • Slide 11
  • Professional Fatigue Syndromes: A Concern for the Helping Professions APA - Advisory Committee on Colleague Assistance Impaired Professionals. AMA- Physician Impairment: physical, mental, and behavioral disorder that hinders the physicians ability to safely treat patients safely. American Nurses Association- Compassion Fatigue. ACA Task Force on Counselor Wellness and Impairment: -Educate counselors on prevention strategies -ID resources counselors -Intervention and treatment recommendations -Advocate for professional counseling associations to establish programs on counselor impairment
  • Slide 12
  • Ethical Considerations in EF Counselors are alert to the signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when such impairment is likely to harm a client or others (ACA; p. 9 Section C.2.g) Counselors shall seek assistance for problems that reach the level of professional impairment, and if necessary, they limit, suspend, or terminate their professional responsibilities until such time it is determined they may be safe to resume their work (ACA; p. 9 Section C.2.g)
  • Slide 13
  • Epidemiology of Empathy Fatigue: How is EF Experienced? Empathy and compassion is the foundation of counselor pre-professional training (Rogers; Corey & Corey; Ivey & Ivey) Intense interactions requires intense listening and results in intense parallel experiences. Many counselors spend a tremendous amount of energy trying to understand the meaning of their clients exp. Theres a cost for counselors searching through their clients emotional scrapbook looking for all the losses, grief, pain, and suffering.
  • Slide 14
  • Theoretical EF: Critical Pathways Counselors who use empathy-focus therapeutic interactions may be more at risk for EF. EF is an unconscious process where the professional and those around them may not recognize counselor fatigue. EF can occur early-on developmentally in supervisees due to pre-existing personality traits, general coping resources, age, counselor-developmental factors, opportunities in clinical experiences to build resiliency, organizational, and environmental supports.EF can occur early-on developmentally in supervisees due to pre-existing personality traits, general coping resources, age, counselor-developmental factors, opportunities in clinical experiences to build resiliency, organizational, and environmental supports. EF is cumulative and ranges on a continuum of low, moderate, and high levels of physical-emotional-mental spiritual, and occupational exhaustion. Can be both acute and cumulative.
  • Slide 15
  • Theoretical Empathy Fatigue EF (is much like stress) can be experienced by the pre- professional & professional as both an acute, chronic, delayed onset reaction ranges on a continuum. EF experienced by person dealing with a variety of issues- clients daily hassles, stress, grief, loss, addictions, or trauma. Cumulative effects of EF leads to higher levels of the deterioration in the pre-professional counselors coping abilities and resiliency.
  • Slide 16
  • Consequences of Empathy Fatigue? - Depletion of the counselors interpersonal effectiveness - Reduced warmth, compassion, intuitiveness - Physiological type of chronic fatigue - Social and Peer-professional withdrawal - Lack of mental focus - Decreased meaning in ones career - Existential confusion - Loss of connection with spiritual or religious practices - Parallel experience with client living life out of balance
  • Slide 17
  • Philosophy of EF It is not necessarily the nature of the clients stress, trauma, loss, grief, daily hassles, unhealthy coping, or disability adjustment issues that creates a sense of EF; rather, it is the counselors perception towards that particular client the counselors attributes that determines the professionals response to it; As a consequence, leads to a diminished capacity to listen, respond empathically, and provide competent professional servicesoverall effects on M-B-S.
  • Slide 18
  • What Are EF Risk Factors? Personality Traits History of MH Problems Maladaptive Coping Behaviors Age and Experience-Related Factors Organizational Factors Job Duties within the Organization Socio-Cultural Factors Persons Response to Past Events Level of Support
  • Slide 19
  • Global Assessment of EF Rating Scale: A Theoretical Measure Theoretical scale: ranging from Level 5(H-EF) Level 1(L-EF). Constellation of States, Traits, Behavioral Dimensions: Cognitive; Behavioral; Spiritual; Process Skills; Emotional; Physical; Occupation. Suggested use: Self-ratings; Ratings by clients; Independent peer-observer; Independent researcher.
  • Slide 20
  • What are Counselors Experience of EF? Think back to the earliest memory in your career as a professional counselor. What did you experience (physically, emotionally, cognitively, spiritually, existentially, and occupationally)- early-on; after a difficult client session- or difficult day in your particular setting?
  • Slide 21
  • Counselors Experience of EF Please discuss some of your more recent client sessions (within the last month). What did you experience (physically, emotionally, cognitively, spiritually, existentially, and occupationally); after a difficult client session