Transcript VT_Conference_Presentation_EUSARF_2014

Vicarious Trauma (VT) for Staff:
Treatment for Second Order Effects
that Improve Outcomes for
Children and Young People in Care
Romaine Moss
[email protected]
Our Out of Home Care Service
 Category 6 Intensive Support Service
 6 residential care houses -accommodate up to 4
young people (10-18 years)
 70 residential care workers – permanent & casual
 24/7 rostered Residential Care Workers
 Staff range in age, educational and employment
backgrounds
Background
• High turnover – loss of knowledge & consistency
• High number of incident reports
• Complex and costly workers compensation claims
• Disempowered Staff – unconsciously identifying
as victims
Elements of VT
• Burnout - long-term exhaustion & diminished interest
• Secondary Traumatic Stress – similar symptoms to PTSD
• Compassion Fatigue – gradual lessening of compassion
• Vicarious Trauma – “The effects of hearing about or
witnessing the aftermath of traumatic events”
• Often suffered in helping professionals where workers
are required to take part in empathic interaction with
trauma survivors (Pearlman & Saakvitne, 1995)
Vicarious Trauma
Detrimental Effects
Secondary Traumatic
Stress
Re-experiencing
Avoidance
Hyper arousal
Cognitive Changes
Frame of Reference changes
Self Capacities
Disruption to psych needs
Pearlman’s ABC Model of Managing VT
 Awareness of the effects of VT
 Balance of work and life
 Connection with people and community
Essential Components of our VT
Management Program
1. Education
2. Risk reduction strategies
3. Monitoring for VT symptoms
4. Early Intervention of VT symptoms
5. Promoting longer term wellbeing
Aim to retain staff in better psychological
health to improve outcomes for Young People
in care
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1. Education
 Acknowledge that VT is inevitable in this work
 Understand the construct of VT
 Recognise the symptoms of VT
 Strategies to manage VT
2. Risk Reduction Strategies –
Leaving work at work
Risk Reduction strategies that
 Reduce exposure to trauma content by building
capacity for individual to “leave work at work”
 Physical & psychological rituals
 Flexible work arrangements
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3. Monitoring for Symptoms
 Critical incident monitoring
 VT Testing – Biannual
 1. Compassion Fatigue Self Test for Practitioners
(CFST – Figley 1995)
Scores for risk of Compassion Fatigue & Burnout
 2. Trauma Attachment Belief Scale

(TABS – Pearlman 2003)


Scores for cognitive schemas about self & others
10 subscales – (Safety, trust, esteem, intimacy &
control) x (self or others)
4. Early Intervention of Symptoms
 Supervision
 Defusing/debriefing following critical incidents
 Employee Assistance Program (EAP)
 VT Intervention Support Line
5. Promoting Wellness - Self Care
Self Care strategies that:
 Address the individual’s VT profile - target
symptoms most experienced or most severely.
 Actively oppose the results of VT – attempt to
offset symptoms & reduce problematic impacts
on the worker
 Funded and non funded
Research Project (2013 – 2015)
 Methodology
 Combined quantitative and qualitative methods/2 phases
 Phase 1:
 Comparative analysis of VT testing (2 x biannual tests – CFST
& TABS)
 12 month qualitative survey (closed & open ended questions)
 12 month analysis turnover, sick leave & worker’s
compensation data.
 Phase 2:
 Repeat above analysis in 12 months
 Evaluation of tailored individual self care plans and VT
Intervention Support Line
 Analysis of Incident report data
Phase 1 - Qualitative Survey results (2013 -2014)
 Supervisors n= 6 & Residential Care Workers n=38
 70% engaged in funded & 87% engaged in non
funded self care
 58% positive impact on team, 52% positive impact
on house
 “by constantly discussing at supervision I am able to talk
about things before they get worse”
 “its positive because workers feel more taken care of. .”
 Being more relaxed at work provides a sense of calm to the
children”
Phase 1 - Cognitive Test Results
 No difference in change in VT levels (n = 34)
 TABS – average to low average range, slight downward
trend but not significant
 CFST - population at high risk for experiencing secondary
traumatic stress symptoms
Phase 1 - Organisational bottom line
 24 % drop in turnover,
 23% drop in sick leave,
 48% drop in workers compensation leave
Initial Recommendations to Manage VT
 Acknowledge the risks – build a culture of
inevitability
 Reduce the risk – Professional development,
supervision & shift handover
 Early Intervention – debriefing, VT Support, EAP.
 Monitor Symptoms – direct & indirect monitoring
 Build Resilience – individual nature of VT, tailored
self care
Quotes:
 “Becoming a Therapist: When trying to help a
broken person always remember that you will be
hurt by their shattered pieces and that is okay.”
(Cornercanyoncounselling.com)
 “In dealing with those who are undergoing great
suffering, if you feel “burnout” setting in, if you feel
demoralised and exhausted, it is best, for the sake
of everyone, to withdraw and restore yourself. The
point is to have a long term perspective” Dalai
Lama
Thank You...
 I would like to acknowledge the work & dedication of
Michael Cashin (OOHC Manager), our 6 house
coordinators & staff for the amazing work that they do.
 I would like to thank the following organisations for their
support of our program.
 Catholic Social Services Australia (CSSA)
 Rape and Domestic Violence Services Australia
 Contact details:
 Romaine Moss ([email protected])