taking care of yourself while working with traumatized children and teens
TRANSCRIPT
IT’S A BALANCING ACT: TAKING
CARE OF YOURSELF WHILE
WORKING WITH TRAUMATIZED
CHILDREN & TEENS
NOVEMBER, 2014
Rachel Freeman, LCSW
Sexual Assault Center
Image credit: http://rpreschern.wordpress.com/2014/03/01/a-balancing-act/
Professional Quality of Life
Compassion Fatigue
Burnout Secondary Trauma
Compassion Satisfaction
www.proqol.org
Helpless* Hopeless* Anger/Cynicism* Denial* Diminished Creativity* Minimizing* Guilt* Fear*
Physical/Emotional Drain* Depression* Loss of Idealism/Spirit* Feeling Alienated* Addiction* Inability to Empathize* Sense that One Can Never Do Enough*
Hypervigilant* Deliberate Avoidance* Dissociative Moments* Grandiosity* Sense of Persecution
Top 10 Signs You’re a Tired Helper
10. Feeling Helpless, Hopeless or Not Good Enough
Am I making an impact? What’s the point? Am I good
enough, smart enough, strong enough?
9. Hypervigilance / Fear
Always being “on”; unrealistic and realistic fears of the
dangers we have been exposed to
8. Diminished Creativity
Loss of energy or desire to be creative, inside and
outside of work
Top 10 Signs continued
7. Minimizing/Persecution/Grandiosity
My work is harder than yours; martyrdom
6. Chronic Exhaustion
Is fatigue an accepted aspect of your work or part of
the workplace culture?
5. Avoidance / Inability to Listen
Turning phone off; too full or too busy to listen any
more?
4. Anger
What does your anger look like? Can become cynical
Top 10 Signs continued
3. Dissociation / Numbing / Desensitization
Difficulty staying present personally or professionally?
Difficulty regulating emotion? Feeling overly
desensitized?
2. Guilt
Feeling guilt over your own successes professionally or
your own personal pleasures
1. Habits in Excess
Burnout
Role ambiguity and role conflict
Tension between personal and professional values
and organizational demands
Bureaucratic constraints on individualization of
consumer services
Lack of service provider autonomy
Inadequate funding
Large caseloads
Excessive paperwork
Concern for the bottom line
Burnout Symptoms
Emotional and/or physical exhaustion
Excessive negative thoughts, especially about job
Irritated or frustrated easily by small problems or
co-workers
Decreased feelings of sympathy
Feeling alone
Feeling unreasonable pressure to succeed
Loss of meaning
The path to tranquility:
“In dealing with those who are
undergoing great suffering, if
you feel ‘burn-out’ setting in, if
you feel demoralized 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
Image credit: www.lifehack.org
Compassion Satisfaction
The Positive Aspects of Healing/Helping
Pleasure and satisfaction derived from working in
helping, care-giving systems
Healing Involvement
May be related to
Providing care
The system
Work and colleagues
Beliefs about self
Altruism
Compassion Satisfaction
When employees experience Compassion
Satisfaction:
Absentee rates are lower
Employees are more productive
Organizational health care costs are lower
Greater physical and mental health of employees
Staff retention rates are higher
Happy and satisfied employees
Quality of services can be greater
Increased employee pride, trust and commitment
So…What are you
willing to do?
“We cannot hold a
torch to light another’s path without
brightening our own.” ~Ben Sweetland
Daily Practice of Caring for Self
Self-care Board
Start a collection of self-care ideas at the office
Creating realistic opportunities
What are you REALLY willing to do?
Creating spaciousness
What are you grateful for?
Make a list
Awareness of triggers
What are your triggers? Have you identified them?
Reframe your response to triggers
Daily Practice of Caring for Self
Attachment
Who are your support people? Who takes care of you?
What’s on your plate? What are the demands in your life? Be detailed.
Cultivation of Plan B
What would you be doing if you weren’t doing this job? What do you dream about?
Reminders of life outside of work
Pictures of family, nature, favorite artwork, etc.
Daily Practice of Caring for Self
Leave work at work
Know that it’s okay to do this
Know you are not alone
You aren’t! Look around the room
Assess your trauma inputs
Where all are you being impacted by trauma throughout your daily routine?
Exercise
Set realistic goals around physical activity
Daily Practice of Caring for Self
Importance of celebrating
Recognize and celebrate successes
Take a break
Take a deep breath. Feel your body.
Constantly refill your love bucket
In order to give to others, you have to take care of yourself
Best Practice Recommendations
“There must be a recognition that the duty to perform
as a helper cannot be fulfilled if there is not, at the
same time, a duty to self-care.” Green Cross Academy of Traumatology
It is unethical for helpers NOT to focus on self-care
Sufficient self-care prevents us from harming those we
serve
Helpers require standards of self-care
Necessary to make teaching about CF, VT and Trauma
Exposure responses a priority for social service
organizations
Agency-Wide Self-Care
Self-Care Standards
Set Policies around staffing difficult cases, debriefing, etc.
Set guidelines and limits around workload
Focus on the positive transformations in our clients
Encourage employees to take adequate sick/vacation time
Validate, normalize, and then respond to CF or VT
Agency-Wide Self-Care cont.
Supervision for everyone
Appropriate boundaries as policy
Good health care plans with good mental health benefits/coverage
Professional development funds and time
Agency-wide fun activities
Provide specific training to helpers on CF, VT, Trauma Exposure Responses AND Self-Care
Multi-Level Leadership support
Communication of Wellness Program / Self-Care Standards
“There is great power in
understanding that we can
change the way we interact
with circumstances in our
lives simply by being
intentional about where we
put our focus.” ~Laura van
Dernoot Lipsky,
Trauma Stewardship, p.175
Just Remember…
It’s okay to put yourself first sometimes
It’s okay to make mistakes
It’s okay to negotiate for change
It’s okay to ask for clarification
It’s okay to ask for help or emotional support
It’s normal and okay to feel and express emotions
You deserve to receive recognition for your work and achievements
It’s okay to say “no” Taken from The Relaxation and Stress Reduction Workbook by M.Davis, M.McKay & E.R.Eshelman
Image credit: www.fivecamels.blogspot.com
Love yourself first, and
everything else falls in
line. You really have to
love yourself to get
anything done in this
world.
~Lucille Ball
“Love doesn’t require that you
ignore or suppress negativity.
It simply requires that some
element of kindness, empathy
or appreciation be added to
the mix. Compassion is the
form love takes when
suffering occurs.”
~Barbara Fredrickson
There is no need to go to
India or anywhere else to
find peace. You will find
that deep place of silence
right in your room, your
garden or even your
bathtub.
~Elisabeth Kubler-Ross
“It is one of the most
beautiful compensations
of life, that no man can
sincerely try to help
another without helping
himself.” ~Ralph Waldo Emerson
Contact Information
Sexual Assault Center
101 French Landing Drive
Nashville, TN 37228
www.sacenter.org
615-259-9055 ext. 338
Rachel Freeman, LCSW, [email protected]
Bibliography and Resources
Babbel, S. (2008). Compassion Fatigue: The bodily symptoms of empathy.
The Journal of the San Francisco Medical Society. 81(5).
Berry, L.L, Mirabito, A.M. & Baun, W.B. (2010). What’s the Hard Return
on Employee Wellness Programs? Harvard Business Review.
Davis, M., et. al. (2008). The Relaxation and Stress Reduction Workbook.
Oakland, CA: New Harbinger Publications, Inc.
Duncan, B. (2011). What therapists want. Psychotherapy Networker. 35(3),
40-47.
Elwood, L.S., Mott, J., Lohr, J.M. & Galovski, T.E. (2010). Secondary
trauma symptoms in clinicians: A critical review of the construct,
specificity, and implications for trauma-focused treatment. Clinical
Psychology Review. 31, 25-36.
Figley, C.R. (2004). Compassion Fatigue Educator Course Workbook.
Florida State University and the Green Cross Foundation.
http://www.gbgm-umc.org/shdis/CFEWorkbook_V2.pdf
Bibliography and Resources
Green Cross Academy of Traumatology. Standards of Self Care.
http://www.greencross.org/index.php?option=com_content&view=artic
le&id=184&Itemid=124
McKay, M. & Sutker, C. (2007). Leave Your Mind Behind: The
everyday practice of finding stillness amid rushing thoughts.
Oakland, CA: New Harbinger Publications, Inc.
Lipsky, L.V. (2009). Trauma Stewardship: An everyday guide to caring
for self while caring for others. San Francisco, CA: Berrett-Koehler
Publishers, Inc.
U.S. Department of Justice. Strategies for Preventing Compassion
Fatigue and Burnout. Sexual Assault Advocate/Counselor Training.
https://www.ovcttac.gov/saact/files/prev_comp_fatg.pdf
Zellmer, D.D. Teaching to Prevent Burnout in the Helping Professions.
Analytic Teaching. 24(1), 20-25.