Stress Management in Child Welfare Practice Trainer:Date:
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Transcript of Stress Management in Child Welfare Practice Trainer:Date:
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Stress Management in Child Stress Management in Child Welfare PracticeWelfare Practice
Trainer:Trainer:
Date:Date:
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Objectives:
As a result of this training, participants will be able to:
☼Identify positive and negative effects of stress and distinguish between them
☼Assess at least two possible sources of stress in the workplace as a child welfare worker and state at least two strategies to mitigate these stressors
☼Identify the differences between Burnout and Secondary traumatic stress
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You can't really be strong until you see a funny side to things."
Ken Kesey
The most thoroughly wasted of all days is that on which one has not laughed.”
Nicolas Chamfort
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What Is Stress?
Hans Selye’s view in 1956 was that “stress is not necessarily something bad – it all depends on how you take it. The stress of exhilarating, creative successful work is beneficial, while that of failure, humiliation or infection is detrimental.” Selye believed that the biochemical effects of stress would be experienced irrespective of whether the situation was positive or negative.
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What is Stress?
The most commonly accepted definition of stress (mainly attributed to Richard S. Lazarus) is that stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize.
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Is Stress Bad for You?
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Some types of Stress Are…
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The human body chemically responds to emotionally
charged situations
When you are under pressure or additional demands have been made your body reacts – fight or flight. Humans naturally want to defend themselves in challenging or difficult situations.
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What happens when my body perceives changes?
Messages travel through the SNS sympathetic nervous system in a bi-directional (two-way) flow. Efferent
messages can trigger changes in different parts of the body simultaneously. For
example, the sympathetic nervous system can accelerate heart rate; widen bronchial passages; decrease motility (movement) of the large intestine; constrict blood vessels;
cause pupil dilation, piloerection (goose bumps) and perspiration (sweating); and
raise blood pressure.
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A friend is a person with whom I may be sincere. Before him I
may think aloud."- Ralph Waldo Emerson
Friendship is the only cement that will ever hold the world together"- Woodrow Wilson
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Stress Feelings
WorryTenseTiredFrightened
ElatedDepressed
AnxiousAnger
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Internalizing Stress
Most of the stress we experience is self-generated. How we perceive life; whether an event makes us feel threatened or stimulated, encouraged or discouraged, happy or sad - depends to a large extent on how we perceive ourselves.
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Ever feel like that “straw”
just landed on your back?
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Types of Stress
o Negative stressIt is a contributory factor in minor conditions, such as headaches, digestive problems, skin complaints, insomnia and ulcers. Excessive, prolonged and unrelieved stress can have a harmful effect on mental, physical and spiritual health.
o Positive stressStress can also have a positive effect, spurring motivation and awareness, providing the stimulation to cope with challenging situations. Stress also provides the sense of urgency and alertness needed for survival when confronting threatening situations.
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Exhaustion
In chronic stress situations, sufferers enter the exhaustion phase: emotional, physical and mental resources suffer heavily, the body experiences ‘adrenal exhaustion’ leading to decreased stress tolerance, progressive mental and physical exhaustion, illness and collapse.
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Ever feel like you
can’t believe
you made it through another
day?
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Symptoms of Stress
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Stress has been related to such illnesses as
Cardiovascular disease
Immune system disease
Asthma Diabetes Digestive disorders
Ulcers Skin complaints -
psoriasis Headaches and
migraines Pre-menstrual
syndrome Depression
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Cost of StressStress helps account for two-thirds of family doctor visits and, according to the U.S. Centers for Disease Control and Prevention, half the deaths to Americans under 65. It has been implicated in heart, stomach and mental disorders, along with the more ordinary headaches, backaches and high blood pressure and cholesterol. Kiecolt-Glaser's 10-year study of medical students found decreased levels of the body's natural killer cells, which fight infections and tumors, during even the familiar stress periods of exams.
Source Sickness Can Be Price of Unbridled Stress By Kevin Lamb
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Secondary Traumatic Stress,
Compassion Fatigue, Vicarious Trauma &
Burnout…
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Do they mean the same thing?
How are they different?
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Compassion Fatigue
Although often used as a synonym for Secondary Traumatic Stress, it is different.
The combination of burnout and Secondary Traumatic Stress results in Compassion Fatigue.
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Vicarious Trauma
Can be used interchangeably with Secondary Traumatic Stress
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Does Secondary Does Secondary Traumatic StressTraumatic Stress
==
Burnout?Burnout?
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Activity:Differentiating STS
from Burnout
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Does Secondary Does Secondary Traumatic StressTraumatic Stress
== Burnout?Burnout?
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The time to Relax is
when you don’t have
time for it. ~Unknown
Tension is who you think you
should be. Relaxation is who you are."
~Chinese Proverb
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Burnout
““a state of physical, a state of physical, emotional and mental emotional and mental exhaustion caused by long exhaustion caused by long term involvement in term involvement in emotionally demanding emotionally demanding
situations.”situations.” (Nelson-Gardell, (Nelson-Gardell, 2003)2003)
Gradual Onset
““the index of the the index of the dislocation between what dislocation between what people are and what they people are and what they
have to do.”have to do.” (Maslach, Leiter, (Maslach, Leiter, 1997)1997)
““describes a syndrome that goes describes a syndrome that goes beyond physical fatigue from overwork. beyond physical fatigue from overwork. Stress and emotional exhaustion are a Stress and emotional exhaustion are a part of it, but the hallmark of burnout is part of it, but the hallmark of burnout is the distancing that goes on in response the distancing that goes on in response
to overload.”to overload.” (Maslach, 1997)(Maslach, 1997)
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Burnout: Indicators
Erosion in values, dignity, spirit and will-an erosion of the human soul
Over time; imbalance of what you can give and provides less than what you need
Feel overworked, undervalued, no longer in control of the job you do
Presence of negative emotions and the absence of positive ones
Sensibilities, Inc. 2005
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Secondary Traumatic Stress
The pain and helplessness of the children we The pain and helplessness of the children we come into contact with can be passed on to come into contact with can be passed on to those around them…those around them…
A “trauma” is a psychologically distressing A “trauma” is a psychologically distressing event that is outside the range of usual event that is outside the range of usual human experience. Trauma often involves a human experience. Trauma often involves a sense of intense fear, terror and helplessnesssense of intense fear, terror and helplessness
Trauma is an experience that induces an Trauma is an experience that induces an abnormally intense and prolonged stress abnormally intense and prolonged stress responseresponse
Source: Child Trauma Academy
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Secondary Traumatic Stress
The response a person The response a person experiences after listening experiences after listening empathetically to the empathetically to the traumatic events in traumatic events in
someone else’s life.someone else’s life. (Nelson-(Nelson-Gardell, 2003)Gardell, 2003)
Sudden Onset
38% of Social Workers 38% of Social Workers experience moderate to experience moderate to high levels of secondary high levels of secondary
traumatic stress.traumatic stress. (Cornille & (Cornille & Meyers, 1999)Meyers, 1999)
Contrary to popular belief it is not just the horrendous cases of abuse, like child deaths or serious injuries, that are secondarily traumatizing for caseworkers. Secondary trauma is cumulative. Even the small things, like seeing sadness in a child’s eyes when a home visit ends, can be traumatizing for a caseworker. Witnessing these events over and over again can have a negative effect on even the most compassionate and resilient caseworkers.
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Who is at risk of Secondary Trauma?
Historically:– Emergency Services
ProfessionalsPolice officersFire fightersEmergency Medical
TechniciansNurse Crisis workers
Recently:– Professionals who
work with children & families in crisisPediatriciansPsychologistsPsychiatristsCPS Social WorkersJuvenile ProbationFoster ParentsTeachers
Source: Child Trauma Academy
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Wrinkles should merely indicate where smiles
have been. ~Mark Twain
Start every day with a smile and get it over with. ~W.C. Fields
A smile is something
you can’t give away, it
always comes back to
you. ~Unknown
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Research
There has been a great deal of There has been a great deal of research on the effects of listening to research on the effects of listening to other people’s traumatic stories as it other people’s traumatic stories as it relates to mental health professionals, relates to mental health professionals, post 9/11 service personnel, crisis post 9/11 service personnel, crisis counselors, doctors, and nurses. But counselors, doctors, and nurses. But only recently have researchers begun only recently have researchers begun to look at the phenomena of to look at the phenomena of Secondary Trauma and how it effects Secondary Trauma and how it effects Child Welfare Social Workers Child Welfare Social Workers
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Exposure
Child Welfare Social Workers are Child Welfare Social Workers are exposed to different forms of exposed to different forms of
traumatic events on a daily basis. traumatic events on a daily basis. They are required investigate child They are required investigate child abuse, remove children from their abuse, remove children from their homes, interact with angry, hostile homes, interact with angry, hostile
parents, the court and all the while be parents, the court and all the while be supportive and nurturing while supportive and nurturing while
listening to horrible stories of child listening to horrible stories of child abuse and neglect. abuse and neglect.
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Why are you at risk?
Empathy: Social Worker internalization of the child’s trauma related pain
Insufficient Recovery Time: Listening to children describe horrific situations over and over again without enough time to process
Unresolved Personal Trauma: Your own traumatic experience can be “re-activated” when working with someone in a similar circumstance
Children are the most vulnerable members of our society: At times, the senseless nature of some of the trauma inflicted on children shake’s ones sense of humanity
Isolation & Systemic Fragmentation: Individual service delivery vs. team oriented practice and high turnover decreases your ability to handle stress
Lack of Systemic Resources: Lack of economic and personal investment in front line services
Source: Child Trauma Academy
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Risk Factors-Child Abuse Risk Factors-Child Abuse HistoryHistory
Personal history of Personal history of child abuse child abuse increases the risk increases the risk of a social worker of a social worker experiencing experiencing secondary trauma secondary trauma (Nelson-Gardell, 2003) (Nelson-Gardell, 2003)
Personal choice to Personal choice to enter social work enter social work after being abused after being abused as a child might as a child might indicate indicate overcompensation overcompensation (Adler, 1917, 1927)(Adler, 1917, 1927)
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Risk Factors-Coping StylesRisk Factors-Coping Styles
Defensive CopingDefensive Coping– Turn away or deny Turn away or deny
problems existproblems exist– Self- deceptionSelf- deception– Reality distortionReality distortion– Protect self from Protect self from
emotional pain or emotional pain or traumatrauma
– Primarily unconsciousPrimarily unconscious– Not always Not always
maladaptivemaladaptive
Constructive CopingConstructive Coping– Confronting Confronting
problemsproblems– Realistic Realistic
expectations of selfexpectations of self– Recognize potentially Recognize potentially
disruptive reactions disruptive reactions to stressto stress
– Protecting self Protecting self against the physical against the physical effects of stresseffects of stress
(Source: Weiten, W. 2008)
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Risk Factors-EmpathyRisk Factors-Empathy
A key feature of child welfare work is building relationships with children and their families. Empathy, interpersonal sensitivity and caring are crucial to making the needed relationships happen. Although necessary, empathy makes the social worker vulnerable to secondary traumatic stress.
(Source: Educating Child Welfare Workers about Secondary Traumatic Stress, Pryce & Shackleford, 2007)
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Cognitive SchemasCognitive Schemas
Research shows that the cognitive schemas are altered after working with trauma clients These traumatic experiences become integrated into the social worker’s cognitive schemata
(Source: McCann & Perlmann, 1990 and Bride, (Source: McCann & Perlmann, 1990 and Bride, 2007)2007)
SafetyTrust/DependencyIndependence
PowerEsteemIntimacyControl
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Signs and Symptoms of STSSigns and Symptoms of STS
TiredTired Less socializingLess socializing Lower productivityLower productivity HopelessnessHopelessness DespairDespair CynicismCynicism Question humanityQuestion humanity
Persistent anger or Persistent anger or sadnesssadness
Disturbing mental Disturbing mental imagesimages
AnxietyAnxiety NightmaresNightmares Decreased sense of Decreased sense of
safetysafety
(Siegfried, 2008)
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Strategies to Combat Strategies to Combat Secondary TraumaSecondary Trauma
Activity
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Strategies Strategies to Combat to Combat Secondary Secondary
TraumaTrauma
Build ResilienceBuild Resilience
– Healthy Self-esteem is Healthy Self-esteem is necessary to necessary to effectively work in effectively work in child welfare and child welfare and minimize the effects of minimize the effects of secondary traumasecondary trauma
– Be open to life’s Be open to life’s opportunities.opportunities.
Developmental Developmental PsychologyPsychology
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Strategies Strategies to Combat to Combat Secondary Secondary
TraumaTrauma
Build a Supportive Build a Supportive Team EnvironmentTeam Environment
– Reduce caseloads Reduce caseloads – Hire and retain quality social Hire and retain quality social
workers workers – Educate on Secondary TraumaEducate on Secondary Trauma– Offer mental health services to Offer mental health services to
support social workers support social workers – Encourage time offEncourage time off– Offer peer support groups Offer peer support groups – Demonstrate support to the Demonstrate support to the
community and mediacommunity and media– Recognize Secondary trauma as Recognize Secondary trauma as
a real issuea real issue
OrganizationalOrganizational
PsychologyPsychology
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Not an appropriate Organizational approach…
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Strategies Strategies to Combat to Combat Secondary Secondary
TraumaTrauma
Build a Social Build a Social NetworkNetwork
– Spend time with Spend time with emotionally healthy emotionally healthy children to encourage children to encourage hope hope
– Maintain friendships Maintain friendships outside of workoutside of work
– Engage in peer support Engage in peer support groupsgroups
SocialSocial
PsychologyPsychology
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STS is NOT a sign of Social Worker weakness
Secondary Trauma is a real issue for Secondary Trauma is a real issue for child welfare social workers. Although child welfare social workers. Although
there is likely no way to avoid it there is likely no way to avoid it altogether, there are ways to mitigate altogether, there are ways to mitigate
the effects. Just as individuals need take the effects. Just as individuals need take responsibility for their own emotional responsibility for their own emotional
health, organizations need to take health, organizations need to take responsibility for their employee’s well-responsibility for their employee’s well-
being being
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The soul would have no rainbow had the eyes no
tears. ~John Vance Cheney
Tears are the safety valve of the heart when too much
pressure is laid on it. ~Albert Smith
What soap is for the body, tears
are for the soul.
~Jewish Proverb
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When experiencing high levels of stress
Make big decisionsBlame othersExpend energy
complainingTry a quick fix
Reframe: Determine other
approaches to the issue or concern; ask advice from co-workers
Think outside the box
Don’t Do
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Activity
What are some of the things you have done or techniques you have used to reduce your stress at work?
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Build on Coping SkillsPay attention to nutritionWhat are your eating
habits?Exercise regularlyConsistency vs. intensityHave regular check-upsMedical and dental careRelax, relax, relaxMeditation, yoga,
reading, taking a nap
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Develop Self-Help
Social workers frequently ask clients who are their support systems when case planning, but do social workers think about their own support system.
How often does a social worker rush to say something to a client or other collateral parties on a case? Do you take time to ‘breathe’ before speaking.
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Develop Self-Help
Ask for help - express to your supervisor how you may be feeling overwhelmed. Top performers can be burned out very easily by constantly handling complex,
emotionally charged cases which can be stressful - To de-stress, discuss caseload
with supervisor and don’t be afraid to ask for help.
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Develop Self-Help?
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Guidelines for Successful Stress Management
☻Establish clear, specific obtainable goals.
☻Start small changes to managing stress.
☻Start from where you are, and build towards your goal.
☻Make one change at a time.
☻Plan ways to manage stress.
☻Reward yourself for good work.
☻Look for ways to control your life.
☻Manage stress on a daily basis.
☻Find humor and laugh.
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Stress Management: 3 Simple Movements
1. Step Back
2. Take a Deep Breath
3. Dive Back In
(Source: Stress Management, Denham, T.)
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Some- times
we have to be “Real”
!
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