Compassion Fatigue Powerpoint - Partners Ending Homelessness
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Transcript Compassion Fatigue Powerpoint - Partners Ending Homelessness
Jan Laughinghouse, Ph.D., LCSW, LCAS, CSI
DISCLAIMERS
Not a discussion of agency-specific issues
Use of terms: therapeutic (read: healing); clinician
(read: staff, or insert your title); client (read: consumer,
individual, customer, resident, student or other
preferred title)
THE STRESSES OF HELPING
Vicarious traumatization
Modeling and reinforcing of workaholism
Burnout or compassion fatigue
Working in isolation (though among many)
Underpaid and Undervalued
STRESS
Most commonly accepted definition (attributed to
Richard Lazarus)
“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.” (Source: mindtools.com/stress/UnderstandStress)
Normal part of life
Cannot be avoided
Not always precipitated by negative events
EFFECTS OF STRESS
Stress is a health issue that can affect us as follows:
Lack of energy
Trouble concentrating
Sleep disturbances
Increased anxiety
Gastrointestinal problems (diarrhea, upset stomach)
Muscle aches/tension
Headaches
Abuse of substances
Fluctuations in weight (Source: Cleveland Clinic)
ASSESSING STRESS
Holmes & Rahe Stress Scale (1967)
Published as Social Readjustment Rating Scale (SRRS)
Medical records of 5,000 patients examined
Patients tallied 43 life events based on a relative score
Determined positive correlation between patients’ life
events and their illness
Subsequent research conducted to validate the link
between stress and illness
Has cultural validity (tested on African American,
Caucasian and Hispanic groups; also with Japanese and
Malaysian groups) wikipedia.org
SCORES
Score of 300+: At risk of illness (90% chance)
Score of 150-299: Risk of illness is moderate (reduced
by 30% from the above risk)
Score <150: Slight risk of illness
wikipedia.org
INTRAPERSONAL AND EXTERNAL
FACTORS THAT COMPOUND STRESS
Intrapersonal
Inherited personality traits
Worldview
How one processes information
Inability to communicate with others
FACTORS (CONT’D)
External
Cultural background
Health
Religion
Education
Work history
Living environment
Socioeconomic background
STRESSES UNIQUE TO WORK IN HUMAN
SERVICES
Emotional contagion (Miller, Stiff, & Ellis, 1988)
Secondary traumatic stress (Figley, 2002)
Traumatic countertransference (Herman, 1997)
Compassion fatigue (Figley, 2002)
Vicarious traumatization (McCann & Pearlman, 1990)
Reactions that occur because “the process of empathizing with a
traumatized person helps us to understand the person’s experience of
being traumatized, but, in the process, we may be traumatized as well.”
(Figley, 1995, p.15)
Along with vicarious trauma helping professionals
experience
Professional crises (budget cuts, client death, violence
against a a colleague in the workplace)
Community crises (natural disasters)
Unfinished business from previous crises
Current personal life crises (illness/death of a loved one,
divorce, financial crises)
WORKAHOLISM
(MODELED/REINFORCED)
Overfunctioning is a learned behavior (Sussman,
1992).
Characterizes the working style of many agencies and
clinicians
Other-centeredness
Vicious cycle
Emotional exhaustion
Fatigue
Detachment
VS.
Accomplishment
Role satisfaction
Pleasure of engagement
(Figley, 2002; Norcross, 2000; Rupert & Kent, 2007)
BURNOUT/COMPASSION FATIGUE
Occupational hazard (Figley, 1995; Pulido, 2007)
Results from interacting intensely with people with
many severe problems over a long period with poor
support
Symptoms are:
Physical, mental, emotional exhaustion (“I’m worn out.)
Insensitivity to others (I don’t care anymore.”)
Sense of futility or hopelessness (Going out there to visit will not
change anything.”)
Sense of isolation/invalidation (Who cares what we do anyway?”)
(Murphy & Dillon, 2011)
OTHER SIGNS
Withdrawal from family and friends
Emotional numbing
Loss of interest in things enjoyed
Persistent thoughts and images related to the problems of
others
Physical symptoms such as a compromised immune
system, head and back pain, gastrointestinal disturbances,
muscle tightness
Sleep disturbances, including nightmares
Jumpiness; pervasive feeling of uneasiness or tension
Unethical activities (financial or sexual exploitation)
FEELINGS OF ISOLATION
Poor support
Lack of funding
Organizational culture
Feelings of disempowerment, lack of control, and
disenchantment similar to those of our clients
UNDERVALUED/UNDERPAID
Historically undervalued, underpaid, and undersupported
Other professions enjoy
Greater pay
Greater benefits
Greater respect
Does it matter that we
Have education?
Have years of experience?
Provide an important community service?
Are willing to work with populations marginalized by other
professions?
(Murphy & Dillon, 2011)
PERSONAL ASSESSMENT
Burnout Assessment
&
Discussion
STRATEGIES OF SELF-CARE
Identify what sustains you and what does not
Work settings
Colleagues
Types of support (Sweitzer & King 2009)
Someone who listens without advising
Sound advise when it’s needed
Praise from “fans”
Friends to relax and play with
“Chicken soup people” who comfort
People who challenge you to go further or deeper
SUPPORT (CONT’D)
The companionship of “buddies” with whom you can
say or do anything without fear
Affirmation and validation from people who’ve had
similar feelings or experiences (p. 27)
SELF-EMPATHY (Jordan, 1991)
Value yourself
Think about your needs differently
Connect with others to experience
Rest and renewal
Support and validation
Self-actualization
Effectiveness at home and at work
(Murphy & Dillon, 2011)
TAKING PERSONAL TIME AND
SPACE
Relax and nurture self
Self care should be routine and not accidental
Limit exposure
Take some time away (personal/vacation time)
GOOD HEALTH PRACTICES
Regular exercise
Healthy diet
Minimizing use of substances
Caffeine
Nicotine
Alcohol/other drugs
Work breaks
POWER OF HUMOR
Cartoons
Sayings
Reflect on human folly
Nothing that hurts or offends
THE VARIOUS MENTAL DISORDERS OF
WINNIE THE POOH CHARACTERS
(thejailbreak.com)
CONNECTING WITH LIKEMINDED OTHERS
Family/friends
Hobbies
Cultural rituals
Spiritual retreats
Provide opportunities for creative expression, feedback,
and friendship
Connections not made around discussions of workplace
stress
SPIRITUAL RESOURCES
Meditation
Mindfulness
Prayer
96 fifteen-minute blocks in 24-hour period
Use 10-15 to pray/meditate
Help alleviate sleep problems due to worry
DO CREATIVE THINGS THAT PLEASE
YOU (Create meaningful experiences)
Gardening
Working out
Sports
Playing an instrument
Quilting or knitting
Listening to music
Writing poetry
Reading
Cooking
TALK WITH OTHER STAFF
Angry/negative ventilation in a peer group
Exercise balance
Too much negativity can lead to cynicism and
hopelessness
Focus on examples of strength and resiliency
(Dr. Beverly Smallwood)
Incorporate the “”hardiness factors
Commitment
Control
Challenge (Dr. James Pennebaker)
HOW TO COPE: RECAP
“Burnout is a state of emotional, mental, and physical exhaustion caused
by excessive and prolonged stress. It occurs when you feel overwhelmed
and unable to meet constant demands. As the stress continues, you
begin to lose the interest or motivation that led you to take on a certain
role in the first place” (helpguide.org)
Assess yourself
Care for your physical and emotional well-being
Acknowledge and express your feelings
Limit exposure
Create meaningful experiences in your life.
(Dr. Beverly Smallwood)
QUESTIONS?
REFERENCES
Figley, Charles (Ed.). (1995). Compassion fatigue:
Coping with secondary traumatic stress disorder in
those who treat the traumatized. New York:
Brunner/Mazel
Figley, Charles R. (2002). Compassion fatigue:
Psychotherapists’ chronic lack of self care. Journal of
Clinical, 58(11), 1433-1441.
Herman, Judith. (1997). Trauma and recovery. New
York: Basic Books
REFERENCES (CONT’D)
Jordan, Judith. (1991). Empathy and self-boundaries.
In Judith V. Jordan, Alexandra G. Kaplan, Jean Baker
Miller, Irene Stiver, & Janet Surrey (Eds.), Women’s
growth in connection: Writings from the Stone Center
(pp.67-80). New York: Guilford
McCann, Lisa & Pearlman, Laurie Ann. (1990).
Vicarious traumatization: A framework for
understanding the psychological effects of working
with victims. Journal of Traumatic Stress Studies, 3,
131-149.
REFERENCES (CONT’D)
Miller, K.I., Stiff, J.B., & Ellis, B.H. (1988).
Communication and empathy as precursors to
burnout among human services workers.
Communication Monographs, 55, 336-341.
Murphy, B. & Dillon, C. (2008). Interviewing in action
in a multicultural world. (4th ed.). Belmont, CA:
Thomson Brooks/Cole
Norcross, John C. (2000). Psychotherapist self care:
Practitioner-tested, research-informed strategies.
Professional Psychology: Research and Practice, 31,
710-713.
REFERENCES (CONT’D)
Pulido, Mary L. (2007). In their words: Secondary
traumatic stress in social workers responding to the
9/11 terrorist attacks in New York City. Social Work, 52,
279-281.
Rupert, Patricia A., & Kent, Jamie S. (2007). Gender
and work setting differences in career-sustaining
behaviors and burnout among professional
psychologists. Professional Psychology: Research and
Practice, 38, 88-96.
REFERENCES (CONT’D)
Sussman, Michael B. (1992). A curious calling:
Unconscious motivations for practicing psychotherapy.
Northvale, NJ: Jason Aronson.
Sweitzer, H. Frederick & King, Mary A. (2009). The
successful internship. Pacific Grove, CA: Brooks/Cole
Cengage.