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COST OF EMPATHY
Child & Family Services
Frontline Staff Workshop
Facilitators: Connie Miller &
Jacquie Aitken Kish
Where do we fit ?
PTSD
Post Traumatic Stress
Disorder(D.S.M.,1980)
Rapid onset burnout &
Gradual Burnout
Grief
(Mitchell, 1975)
STSD
Burnout
Secondary Traumatic
Stress Disorder
(Figley,1982)
(Freudenberger, 1974)
Vicarious
Traumatization
Compassion Fatigue
(Pearlman,1990)
(Joinson, 1992)
Depression(D.S.M.)
Background
Questionnaire
BACKGROUND QUESTIONNAIRE
1. Age
25 - 30 ___
40 - 45 _____
55 - 60 _____
30 - 35 _____
45 - 50 _____
60 - 65 _____
35 - 40 _____
50 -55 _____
Male _____
Female _____
2. Gender
3. Number of years working with victims of trauma/abuse/ or individuals in crisis.
Frontline
Supervisory
0 – 2 years
__________
__________
2 – 5 years
__________
__________
5 -10 years
__________
__________
10 -15 years
__________
__________
15 – 20 years
__________
__________
20+ years
__________
__________
4.Have you supported a colleague who presented burnout or trauma related to their work with victims of trauma/abuse?
Yes __________
No __________
On one occasion __________
2 - 5 occasions _________
5 - 10 occasions __________
Over 10 occasions __________
5. Have you identified within yourself symptoms of stress that you believe are related
to your work with victims of trauma/abuse/crisis?
Yes __________
No __________
If yes, do you identify them arising from : (check as many as apply)
_____ an incident when my safety was at risk
_____ a physical assault on self
_____ a verbal attack or threat on self
_____ an incident where I witnessed trauma to a client
_____ dealing with a complete suicide of a client
_____ Other _________________________________________
If yes, when you were experiencing the stress, did you feel supported by?
YES
NO
SOMETIMES
Friends & Families
______
_______
______
Colleague’s
_______
_______
_______
Supervisor
_______
_______
_______
The department
_______
_______
_______
6.
Have you received formal education regarding burnout/vicarious trauma?
Yes _______
No _______
If yes, specify: _________________________________________________
_____________________________________________________________
_____________________________________________________________
Burnout:
Can be described as an erosion of
the soul, a feeling that regardless
of what the person does, they
cannot make a difference in their
work place.
• This might be accompanied by feelings of hopelessness
• A loss of motivation
• A sense of mismatch between what you are capable
of and what is expected.
That’s why more people see burnout as
being off purpose, not just
overwhelmed.
Dr. Jane Simington, Phd, Taking Flight International
Life in Balance
Ability to
cope
stress
Self care
stress
stress
Crisis: When stress overwhelms one’s ability to cope
Ability to
cope
Stress
One event
can
Overwhelm
Major loss/critical
incident/assault
Shock, disbelief,
denial
Daily
stress
& all the
implications
Life
stress
STRESS
Stress can
Build:
Gradual
Burnout/
Vicarious
trauma/
Depression
Small issue
Small issue
Small issue
Small issue
Small issue
New issues/loss
may open
unresolved pain
MAJOR LOSS
&/or Similar loss
Major pain/issue
from the past
Sources of Stress
Personal Life
Work Life
• Self capacities
• Personal safety
• Past experiences
• Intimate relationships
• Boundaries
• Nature of the client
• Nature of the work
• Physical environment
• Nature of the work
place
• Context of the work
Exercise
1. Chose client experiences that
have stayed with you – could be
fairly recent or in the past but not
ongoing. (Chose a negative and
positive experience.)
2. Share the experience with your
group – including how you coped
with the situation and what you
learned.
3. The groups role is to listen and
provide supportive feedback –
support the speaker.
4. Monitor your reactions and then
as a group, brainstorm what were
helpful debriefing techniques
Impact of Stress and Burnout
Cognitive
Emotional
Physical
Behavioral
Impact of Stress and Burnout
Cognitive:
poor concentration
memory problems
poor attention span
slowed problem solving
difficulty making decisions/calculations
Impact of Stress and Burnout
Cognitive:
poor concentration
memory problems
poor attention span
slowed problem solving
Difficulty making decisions/calculations
Emotional: mood swings
depression
anxiety, fear
overwhelmed
Impact of Stress and Burnout
Cognitive:
poor concentration
memory problems
poor attention span
slowed problem solving
Difficulty making decisions/calculations
Emotional: mood swings
depression
anxiety, fear
overwhelmed
Physical:
muscle tremors
chest pain
difficulties breathing
elevated blood pressure
Impact of Stress and Burnout
Cognitive:
poor concentration
memory problems
poor attention span
slowed problem solving
Difficulty making decisions/calculations
Emotional: mood swings
depression
anxiety, fear
overwhelmed
Physical:
muscle tremors
chest pain
difficulty breathing
elevated blood pressure
Behavioral: withdrawn
excessive silence
change in work habits easily frustrated
sleep disturbances
change in hygiene
Compassion Fatigue
•A condition characterized by a gradual
lessening of compassion over time. Sufferers
can exhibit symptoms including
hopelessness, decrease in pleasure, and
pervasive negative attitudes. Sufferers
develop new feelings of incompetency and
self doubt.
•It can have a detrimental effect on individuals
both, personally and professionally.
Compassion Satisfaction/Fatigue Test
Burnout (CHECK)
Compassion Fatigue (CIRCLE)
- 36 or less = extremely low risk
- 37 - 50 = moderate risk
- 51 – 75 = high risk
- 76 - 85 = extremely high risk
- 26 or less = extremely low risk
- 27 – 30 = low risk
- 31 – 35 = moderate risk
- 36 - 40 = high risk
- 41 or more = extremely high risk
Compassion Satisfaction (X)
- 118 & above = extremely high potential
- 100 – 117 = high potential
- 82 – 99 = good potential
- 64 – 81 = modest potential
Below 63 = low potential
Recovery Process
Dealing with
powerlessness &
helplessness
Recognize the value of
our work
Reality confirmation
Placing blame where it
belongs
Our Strength/
Recovery Process
Expressing thoughts &
feelings
Sharing the burden
Breaking down
isolation
Occupational hazard
Dispelling the
minimization of the
experience
Supervision/partnering
control
•0
10
responsibility
•0
10
If you take responsibility for something you have no
control over it will drive you nuts.
William F.
Nelson
Recovery Process
Dealing with
powerlessness &
helplessness
Recognize the value of
our work
Reality confirmation
Placing blame where it
belongs
Our Strength/
Recovery Process
Expressing thoughts &
feelings
Sharing the burden
Breaking down
isolation
Occupational hazard
Dispelling the
minimization of the
experience
Supervision/partnering
Ways of Coping
name
Finding Purpose/Passion
List the things that you do for fun or really enjoy. (parts of your job,
recreation, family life)
Write down the people you admire and why.
List the things that you do naturally without thinking. (eye for detail,
sense of humor, ability to focus)
Finding Purpose/Passion
List the things that you do for fun or really enjoy (pats of your job,
recreation, family life)
Write down the names of people you admire and why.
List the things that you do naturally without thinking about it (eye for
detail, sense of humor, ability to focus)
Listen to the Voice Inside to
guide you to your true desires
Purpose
• Purpose is often seen for the future but try to find ways to start now:
• Have a side project close to your heart
• Try to introduce something reflecting your purpose in some aspect of work
• Try to express in the interaction with others
Prevention
Prevention
• Increase self awareness/reflection
• Engage social supports
• Mobilize organizational supports
• Engage in self care/self soothing
activities
Remember
• Stress management techniques are useful before you are stressed or
are in the early stages of stress. If you are severely stress such course
are of little value.
• It the becomes a case of rearranging deck chairs on the Titanic.
• Stress management at this point is ineffective because it can make
people feel worse. The whole premise of stress management is that
you are still coping.
We were born to live, not just survive
Though the road be long and the river wide
Though the seasons change and the willows bend
Though some dreams break some others mend
Though we are born to give and born to take
To win and lose and to celebrate
We were born to know and born to muse
BORN TO LIVE
Ann Mortifee
To unfold our hearts, take a chance to choose.
We were born to love, though we feel the thorn
When a ship sets sail to return no more.
Though we’re born closed and we feel pain
To chance it all and to love again
We were born to reach, to seek what’s true
To surrender all, to make each day new.
We were born to laugh and born to cry
To rejoice and grieve just to be alive.
We were born to hope and to know despair
And to stand alone when there’s no one there.
We were born to trust and to understand
That in every heart there’s an outstretched hand.
We were born to love, to be right or wrong,
To be false and true, to be weak and strong.
And to know to live, to break down the wall
And to know that life is to take it all.
Thank You!
Questions
Evaluations
Resources
The Theory of Positive Disintegration
by Kazimierz Dabrowski.
Level 5 –Secondary Integration
Level 4 – Directed Multilevel Disintegration
Level 3 – Spontaneous Multilevel Disintegration
Level 2 – Unilevel Disintegration
Level 1 – Primary Integration