compassion fatigue (cf) secondary traumatic stress (sts ... compassion fatigue a state of exhaustion

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  • Compassion Fatigue (CF) Secondary

    Traumatic Stress (STS) Concerning

    High Risk/High Need Participants

    UNDERSTANDING, ASSESSING, AND LIFESTYLE CHANGES TO ADDRESS COMPASSION FATIGUE

    LAWRENCE GILBERT LPC LADC

    JENNIFER GILBERT LPC(C) LADC(C)

    KAREN GILBERT PT

  • WORKSHOP GOALS &

    OBJECTIVES

     What is Compassion Fatigue/Secondary Traumatic Stress

     Identify target population’s “condition(s)” that could possibly contribute to the CF/STS

     Identify symptoms of CF/STS in shifts of cognition, workplace, and interpersonal areas

     Implement lifestyle changes for CF/STS management

    Traumatologist Eric Gentry:

    Individuals who are attracted to care giving often enter the field already experiencing C/F. A strong identification with helpless, suffering or traumatized people could possibly the

    motive to enter the medical field

    2017 Compassion Fatigue Awareness Project Patricia Smith is the founder and CEO of the Compassion Fatigue

    Awareness Project© www.compassionfatigue.org

    http://www.compassionfatigue.org/

  • WHAT IS

    COMPASSION FATIGUE

     A state of exhaustion and dysfunction

    (biologically, psychologically, and socially)

    as a result of prolonged exposure to

    secondary trauma or a single intensive event

    Slatten LA, Carson KD, Carson PP. Compassion Fatigue and Burnout: What Managers Should Know. Health Care

    Mgr.2010;30(4):325-333.

  • CS-CF Model

    Professional Quality of Life

    Compassion Satisfaction

    Compassion Fatigue

    Burnout Secondary

    Trauma

    © Beth Hudnall Stamm, 2009. Professional Quality of Life Scale (ProQOL). www.proqol.org. This test may be freely copied as long as (a) author is credited, (b) no changes are made without author authorization, and (c) it is not sold.

  • Compassion Satisfaction

    • The positive aspects of helping

    – Pleasure and satisfaction derived from working in

    helping, care giving systems

    • Maybe related to

    – Providing care

    – To the system

    – Work with colleagues

    – Beliefs about self

    – Altruism

    © Beth Hudnall Stamm, 2009. Professional Quality of Life Scale (ProQOL). www.proqol.org. This test may be freely copied as long as (a) author is credited, (b) no changes are made without author authorization, and (c) it is not sold.

  • Compassion Fatigue

    • The negative aspects of helping

    • The negative aspects of working in helping systems

    may be related to

    – Providing care

    – To the system

    – Work with colleagues

    – Beliefs about self

    • Burnout

    • Work-related trauma

    © Beth Hudnall Stamm, 2009. Professional Quality of Life Scale (ProQOL). www.proqol.org. This test may be freely copied as long as (a) author is credited, (b) no changes are made without author authorization, and (c) it is not sold.

  • Burnout and STS: Co Travelers

    • Burnout

    – Work-related hopelessness and feelings of inefficacy

    • STS

    – Work-related secondary exposure to extremely or

    traumatically stressful events

    • Both share negative affect

    – Burnout is about being worn out

    – STS is about being afraid

    © Beth Hudnall Stamm, 2009. Professional Quality of Life Scale (ProQOL). www.proqol.org. This test may be freely copied as long as (a) author is credited, (b) no changes are made without author authorization, and (c) it is not sold.

  • Burnout

    Perceived Demands

    out weigh

    Perceived Resources

    Perceived Demands

    Perceived Resources

    Schaufeli W, Leiter M, Maslach C. Burnout: 35 years of research and practice.Career Development International.

    2009;14(3):204-220.

  • Secondary Traumatic Stress

    Stressors Perceived Resources

    #1 stressor is

    the events in the

    CLIENT’S LIFE

    out weigh

    Perceive Resources

  • PERSONAL RELATED RISK

    FACTORS

     Elevated Conscientious:

    very careful or vigilant, extreme care/great efforts

     Perfectionists:

    striving for flawlessness, setting high performance standards

     Having small support system:

    isolates from others outside of immediate family;

     Limited feedback loop about thoughts and perceptions

    Killian K. Helping till it hurts? A multimethod study of compassion fatigue burnout, and self-care in clinicians working with trauma

    survivors. Traumatology. 2008;14(2):32-44.

    Potter P, Deshields T, Divanbeigi J. Compassion fatigue and burnout. Clin J Oncol Nurs.2010;14(5):E56-E62

  • PERSONAL RELATED RISK

    FACTORS

     High level of personal stress:

    Parents, spouse, children, close friends,

    finances, health issue

     Previous histories of personal trauma:

    Verbal, physical, sexual

     Women

     Lack of self-awareness (reference)

    Killian K. Helping till it hurts? A multimethod study of compassion fatigue burnout, and self-care in clinicians working with

    trauma survivors. Traumatology. 2008;14(2):32-44.

    Potter P, Deshields T, Divanbeigi J. Compassion fatigue and burnout. Clin J Oncol Nurs.2010;14(5):E56-E62

  • WORK RELATED RISK FACTORS

     Caregiving professions

     Limited supportive work environment

     High level of work environment stress:

    hours, caseloads and responsibilities

     Standards of Care

     Productivity Standards

     Business Models vs Mission

     Supervision

     Co-worker issues

    Kelly Duszak McArdle, PT, DPT, OCS, Cert. MDT Compassion Fatigue: Moving From Fatigued to Resilient – Be a

    Catalyst for Healing CSM 2014. Las Vegas, NV, February 4-6, 2014

  • SYMPTOMS OF CF/STS

     Cognitive Shifts:

    Feelings of hopelessness & helplessness

    Decrease in experiences of pleasure

    Constant Stress

    Anxiety; feeling overwhelmed

    Sleep issues: insomnia or awakenings during the night

    See the “cup as half-empty”

    See deficits, not assets within others

    “Compassion Fatigue –Because You Care” St. Petersburg Bar Association Magazine. 2008

  • SYMPTOMS OF CF/STS

     Relational Shifts:

    Pervasive-negative attitude

    Countertransference

    Impatience

    Limited input

    Disengaged

    Drifting

    Beaton, R. D. and Murphy, S.A. 1995 “Working with People in Crisis: Research Implications” In C. R. Figley, Compassion Fatigue;Coping with secondary traumatic stress disorder in those who treat the traumatized, 51-81. NY: Brunner/Mazel.

  • SYMPTOMS OF CF/STS

     Workplace shifts:

    Absenteeism

    Decreased productivity

    Inability to focus

    Feelings of incompetency and self-doubt

    Isolation from other co-workers

    Struggle to meet deadlines

    Feel disconnected from team members

    Possibly look for other employment or change in career

    2017 Compassion Fatigue Awareness Project Patricia Smith is the founder and CEO of the Compassion Fatigue

    Awareness Project© www.compassionfatigue.org

    http://www.compassionfatigue.org/

  • HIGH RISK/HIGH NEEDS

    CRIMINAL JUSTICE POPULATION

    • likelihood that the individual will reoffend without appropriate interventionHigh Risk

    • barriers that inhibit full treatment engagementHigh Needs

    • housing, transportation, unemployment finances, family issues, mental/physical Responsivity

    • criminal history, neighborhood problems, education/employment/financial, substance use, peer association

    Criminogenic

    10 Key Components of Drug Courts NADCP, 1997

  • DISEASE/ALLERGY/MEDICAL

    MODEL OF ADDICTION

    DISEASE/ALLERGY/MEDICAL MODEL OF ADDICTION

    Alcohol/drug addiction is a chronic disease characterized by drug seeking, use is compulsive/difficult to control, despite harmful consequences

    The pathology (course) of the disease may be know or unknown with specific signs (physical findings) and symptoms (visual findings) that are consistent with addicted persons*

    Nora D. Volkow M.D. George F. Koob PhD, Thomas Mc Lellan, PhD, “Neurobiological advances from the brain

    disease model of addiction”. New England Journal of Medicine 2016

  • THE MEDICAL DISEASE MODEL

    All diseases have 2 features within the pathology:

    Remission: disappearance of signs & symptoms

    Reoccurrence: return of signs and/or symptoms

  • DISEASE/ALLERGY/MEDICAL

    MODEL OF ADDICTION

    * These symptoms are only for a person who is in late abuse or dependency status where cognition &

    emotional functioning have been damaged; leading to

    verbal & physical behaviors that challenge us

    professionally

    Could responsivity & criminogenic

    needs be symptoms of a

    disease?

  • WHAT’S HAPPENING???

    ActionSteps Counseling, Inc. Living the dream

    Lawrence Gilbert LPC LADC

  • Converging Risks

    The Perfect Storm

    Per

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