Do No Harm: Be Emotionally and Physically Fit

Dr. Rosalee Martin, LPC, LCDC, LMSW African American Family Support Conference February 27, 2015

How well we take care of ourselves affects the client who seeks our help!

Objectives

 To present how professional burnout may result in incompetence and therefore harming clients.

 To show how m aintaining good mental and physical fitness is congruent with the ethical principle of "DO NO HARM.“  To provide participants with strategies for maintaining good physical fitness, emotional and mental and spiritual health.

Service providers who do not care for themselves physically, mentally, emotionally, and spiritually, violates the ethical principle: Do No Harm!!!

Our ability to put forth the energy, attentiveness, and best use of our skills towards helping a client is largely determined by what kind of shape we are in…

  

Physically emotionally Mentally



Spiritually We can reduce stress and enhance our effectiveness, both personally and professionally, by attending to all these life areas

Given the stress of working in the helping profession, you may easily be vulnerable to workers' burnout and ineffective intervention.

Not Tending to Personal Needs



Can result in professional burnout



Professional incompetence



Professional liabilities

All of the above harms the clients!

Burnout Defined

 Burnout is a state of exhaustion, whether it is physical, mental, or emotional, which is cause by excessive and tedious stress. Signs of burnout:  Being depressed, drained, fatigued, frustrated  Feeling overwhelmed  Inability to focus  Cognitive difficulty

What Counselors Say

 A mixed-methods survey of 120 clinicians who provide mental health services showed that 58% reported that burnout had a negative impact on either work quality or productivity.

 93% noted that burnout has a negative impact on interactions with colleagues,  87% reported that it negatively affects interactions with patients.

Impact of Burnout: Clinicians Speak Out. Medscape. Feb 10, 2015-also published in the Feb issue of

Psychiatric Services

What Counselors Say

 More than half indicated that burnout reduced productivity and the quality of their work, reporting that it "dulls my clinical skills" and results in "less thorough evaluation and intervention.“  Clinicians also reported that burnout caused them to be less patient (48%), to withdraw or avoid helping others (40%), to have lower energy or motivation (39%), to have poor communication and listening skills (37%), to cause others to have poor attitudes (37%), and to have decreased empathy (35%).

Impact of Burnout: Clinicians Speak Out. Medscape. Feb 10, 2015-also published in the Feb issue of Psychiatric Services

Professionals’ Burnout May result in INEFFECTIVE treatment that can be harmful to the client

     Lack of progress in treatment Legal and ethical liabilities Danger to health, safety and welfare of clients Inability to maintain a professional relationship with clients Experience distraction and agitation

Professionals Who Experience Burnout

     Sometimes are cynical with clients May be watching the clock Can be insensitive to clients Might give wrong diagnosis May provide services when under the influence of alcohol and/or drugs

All of the above might result in high client drop-out rates.

To SUM

Burnout affects how professionals view patients and themselves, and this affects how professionals interact with clients. Additionally, burnout affects how patients view professionals, view themselves, and view the therapeutic relationship.

Case Studies

Case Study One

The counselor has just lost his mother. He takes bereavement leave from the job and returns two weeks later. He is assigned a case. The presenting problem is dealing with loss—the client’s mother.

 Should the counselor accept this case? Why or why not?

  If the counselor takes this case is there a possibility of transference (unconscious redirection of feelings from self to the client)?

What potential harm might the counselor do to the client if he does not deal with his own grief?

Case Study Two

A counselor is upset that he did not get the promotion he thought he deserved. He wanted to do administrative work as he was tired of dealing directly with clients. His caseload was high and he felt unappreciated by his director.

 What should he do?

  How might his behavior impact his clients?

What ethical principles might he violate?

Case Study Three

A counselor has a drinking problem but kept this problem a secret until one day she showed up at the office drunk. Her supervisor referred her to the employee assistant program. The counselor decided to seek counseling for her drinking problem.

 Should the agency give the counselor time off to get the services needed?

   If the counselor has to work while getting service, how competent might the counselor be?

At what point do you think that the counselor can return to work?

Should the counselor say anything to her clients about her situation when she returns?

Case Study Four

The counselor has been working with a client for the past two years. They are both comfortable with each other. One day the client asked the counselor to go to a party with her.

 What ethical principle can inform his decision?

   What will happen to the professional relationship if the worker decides to go to the party?

In what ways might the client be hurt if the counselor goes to the party?

If the counselor decides to go to the party, what might that say about his emotional health?

To

DO NO HARM requires intentional behavior changes

Helping Professionals Must

:

 Have a healthy balance  maintain proper boundaries in professional relationships;  have meaningful relationships and friendships outside relationships with clients;  Be intellectually alert  Be physically, emotionally and spiritually healthy

Create a Balanced Life

 Work-life balance—maintaining this can be a challenge for any working adult, but especially for those of us who are counselors. Develop interests outside your profession---interests are very unique to each person. Whatever makes you happy and takes your mind off work – make it a priority, and make time for it.  Those non-work experiences refresh our minds and relieve the stresses of work. Also important, they give us chances to make tangible accomplishments

Seek Collegial Support

 Reduce stress by building a supportive work environment. Colleagues help to uplift each others’ spirits by managing workloads together.  If the work environment is unhealthy, consider starting a morale committee or planning recognition and reward activities. You may even need to leave.

  Mentor and buddy programs also encourage joint problem-solving.

Learn to say ‘no’ even if you lose some of the support. Taking on too much is hurtful to you and whoever you made the commitment. Delegate responsibilities. Speak up for yourself.

Maintain Supportive Relationships

     Maintain good relationships with family and friends for much needed feedback, a shoulder to lean on, or a different perspective.

Having an objective pair of eyes and ears can give you a whole new way of thinking. Deep relationships are shown to be one of the best sources of happiness, whether family or friends.

You need to know what your limits are especially in relationships.

Avoid keeping secrets in significant relationship.

Maintaining Good Physical Health

Physical Health

 Exercise: strengthening and fine tuning your body.  When you exercise regularly, you will look, feel, and think better.

 Nutrition: feeding your body the building materials it needs.  If you want your body to be solid, you MUST eat right;  Get Plenty of Sleep: sleep 6-8 hours per night is critical for an alert tomorrow;  Drink 6-8 glasses of water.

Develop a Health Plan--Physical

 Diet—pay attention to your diet for one week and note what you eat, how often you eat, where you get your food from, your daily calorie intake. Do you have an eating disorder? If so, what? Develop a plan for changing your eating habits. Develop a healthy diet, Provide information from websites that you use.  Exercise—pay attention to your routine exercise (or lack there of). Develop an exercise plan. Be specific

and realistic and do it!

Our physical health affects our emotional health much more than we realize.

“ OUR GREATEST WEALTH IS HEALTH

."

Emotional Health

Healthy Minds; Healthy Emotions Don't let complacency or boredom or even pain set in. In order to feel alive and vibrant we need to keep our minds active by learning new things and challenging ourselves.

It’s not easy spending every work day delving into clients’ serious personal

problems and trying to help the clients

work through them. The clients’ pain

and suffering can become the

therapists’ pain and suffering, and

even the most dedicated counselors can find the daily grind to be emotionally exhausting.

Improving Emotional/Mental Health

 Stress reduction activities, mental health strategies, etc     First identify sources of stress; good stress (those that motivates) from bad stress (more accurate distress) and

develop strategies for fostering good stress

and reducing bad stress. Identify unhealthy ways you have dealt with your stress (eating, alcohol, shopping, gambling, excessive anger, violence, etc.). Be very specific Dwell on positive; not negative!

Learn to Savor and Appreciate the Moment  How many times have we heard that LIFE IS TOO SHORT? We get so caught up in the whirlwind that we forget to live in the present moment.  Stop worrying about the future. It's time to slow down and enjoy the NOW!

Self-Esteem

 What do you think about yourself?  Do you have positive affirmations and attitudes or are they negative?  Think about your goals and to what extent you are making strategic steps toward achieving them?  What are your strengths and weaknesses?

Be honest and specific!

Be Gentle With Yourself

 Gentleness: treating yourself with care. The willingness to be gentle with yourself is an attitude that will reduce physical and emotional wear and tear.  Attend to your needs and thereby reduce your stress.  Relaxation: cruising in neutral and replenishing your reserve. There are numerous ways to relax. Each method is based upon the principle that your mind and body are connected. Chronic tension must be combated by regular relaxation. You can develop ways to relax that fit your personality and personal interests.

Honor Your Feelings

     Open up: Finding ways to deal with your emotions is another step toward avoiding burnout and being healthy.

Don’t ignore your feelings. Talk to your co-workers, especially if you work in an area with a high rate of client distress Collect Appreciation that is due you – visit some people who help make you feel good. Don’t be quick to dismiss gratitude.

Value who you are as well as what you do.

Be alert to people and things that can steal your joy.

Learn From Your Experiences



Look for the hidden message in negative or

difficult situations. Learn from them. Experiencing adversity is meant to alert you to something or teach you a new skill.  What lessons are embedded in the experience?

Have Fun

.

Have fun and don't take yourself too seriously.

 Take time off; go to the beach, the park or a movie to take your mind off your current situations.

Create After-Work Rituals

 do something else with consistency to mark the end of the work day and the stress associated with it. A ritual can help you unwind.

Laughing confuses an approaching frown!

Laugh, Laugh, Laugh, Laugh

Laugh

 This old man was walking down the street. He heard someone talking to him. He looked around but did not see anyone. He looked down and saw a frog talking to him saying ‘pick me up and kiss me. I will turn into a beautiful princess, willing to marry you.” The old man placed the frog in his pocket. The frog cried out. “Didn’t you hear what I said?” The old man said “yes, but at my age it is more fun having a talking frog.”

Laugh

 This couple had been arguing resulting in them giving each other the silent treatment. The next morning the husband had to go on a trip. That night he placed a note on his wife side of the bed that said wake me up at 5 AM. The next morning he was surprised to see that it was 8 AM resulting in his missing his plane. He woke his wife angrily and asked her why she didn’t wake him up. She said she did. She pointed to a note she placed on his side of the bed that said “get up, it’s 5 am.”

It’s impossible to laugh and be mad at the SAME time. Laughter is healing, therapeutic and life giving!

Engage your Artistic Side

       Poetry Song Art Writing of all genre Designing Sewing, crocheting, knitting, etc Cook a gourmet meal

Spiritual Health

Do you consider yourself a spiritual person? How important is it for you to strengthen your spiritual self? Clarify how you will strengthen your spiritual self?

Spiritual Health

    As we grapple with life events, being physically, emotionally and mentally healthy provide us with strength to go on.

For most that is not enough, as we are also spiritual beings.

Connecting to a power –a God—superior to us needs to be part of the equation if we are to maintain good health.

Experiencing God in a non-oppressive, loving way validates who we are and our own worth.

Spiritual Growth

 Spending time in communion with your spiritual being may help you answer many unanswered questions.

 Your spiritual growth may help you take risks— think outside the box.

 Questions about your value, your mortality, your destiny may be found in your walk with your God.

 Accepting your beliefs as important in your life without having to explain to others why, may give you the peace that is needed.

Learn to Forgive



Forgiveness saves the forgiver more than the on e forgiven

 Saves him/her mental and emotional time dwelling on the person and/or the experience;     Saves the person time to be creative and productive ; Increases positive energy and attitudes; Softens the person’s heart; Draws the person closer to individuals and God;  Saves him/her from undue stress and therefore stress related disorders

Accept Forgiveness and Let Go of Guilt

Consider Getting Some Counseling For Yourself

 Counselors may need counseling!  Working with a counselor may give them what they need to move forward with his/her own clients in a healthy way.

 People have to be good at dealing with their own tragedies, their own losses their own grief—partners leaving them, children growing up and moving out, parents dying. Then they have energy and ideas to help their clients with losses.

Summary Body, mind, and spirit all work together When you take care of your body

, mind and spirit, you are less likely to become burnout and more likely to be effective and competent as a professional;

The converse is true your client!

: when you are unhealthy it increases the likelihood that you might do harm to

Write Your Health Plan: include timelines for implementation!

Bibliography

      

Abernathy, Chip. Professional Ethics: Avoiding Burnout.

captasa.org/2014_Slides/Prof.Eth.Avoid.Burnout.CAPTASA.ppt .

Avoiding Counselor Burnout While Seeking Resilience: An Interview with Thomas Skovholt, University of Minnesota Counseling Psychologist. http://www.counselor license.com/articles/avoiding-burnout-skovholt.html#prefilter .

Davis-Laack, June 24, 2013. 7 Strategies to Prevent Burnout, in Pressure Proof ; Psychology Today (February 5, 2015) https://www.psychologytoday.com/blog/pressure-proof/201306/7 strategies-prevent-burnout .

Impact of BurnoutBurnout: Clinicians Speak Out. Medscape. Feb 10, 2015-also published in the Feb issue of Psychiatric Services.

http://www.medscape.com/viewarticle/839533 .

Noelke English Maples St. Leger Blair, L.L.P. Avoiding professional Burnout, http://www.nems law.com/Burnout .

Sheafor, Bradford and Charles Horejsi. Techniques and Guidelines for Social Work Practice. 9 edition. 2012 Allyn and Bacon, pp 19-23.

10 Tips For Maintaining Mental and Emotional Health. http://www.essentiallifeskills.net/emotionalhealth.html

. Feb. 5, 2015.