Surviving and Thriving During Challenging

Times: Self-Care for the Healer

Theresa Ford, Ph.D., LPC

Keep It Real Conference

October 4, 2010

Where We are NowProfessional helpers today are faced with an

increasingly complex set of challenges that include:

Clients/consumers who have multiple, complicated, and difficult to address needs

Larger caseloads More demands from agencies, such as

additional duties, paperwork, procedures

Where We are Now (continued) Budgetary cutbacks that affect staffing

levels, the availability of resources, and compensation

Working for or with systems that have stringent rules, e.g., managed care, and may not be responsive clients’ or helpers’ needs

Limited structurally-based opportunities for professional growth and support

Where We are Now (continued) Limited external rewards for working under

trying circumstances An agency culture that may “pay lip service”

but does not truly value self-care and time for renewal

Increased activities at home A mistaken belief that the helper doesn’t

need help

Helpers At-RiskOf necessity, effective professional helpers

demonstrate qualities such as empathy, sensitivity, and a genuine sense of caring for those we are charged with helping.

However, those qualities, combined with very demanding jobs and constant expose to individuals who are suffering, put helpers at risk for unhealthy levels of stress, compassion fatigue, and burnout.

Definitions Stress is the body’s response to demands

that can also have psychological, social and behavioral implications.

Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress, leaving the individual feeling overwhelmed and unable to meetconstant demands.

Definitions (continued)

Burnout reduces productivity and saps energy, resulting in feelings of helpless, hopeless, cynical, and resentful. Eventually, the helper may feel he or she has nothing more to give.

(Smith, Jaffe-Gill, Segal, & Segal, 2008)

Understanding Stress and Burnout Stress is characterized by too much, as in

too many clients, too many responsibilities, and too much pressure.

Burnout is characterized by not enough, as in not enough motivation, not enough caring or connection, not enough hope.

(Smith, Jaffe-Gill, Segal, & Segal, 2008)

Stress vs. Burnout Stress Characterized by over-

involvement Emotions are

heightened Produces urgency and

hyperactivity Loss of or too much

energy

Burnout Characterized by

disengagement Emotions are blunted Produces

helplessness and hopelessness

Loss of motivation, ideals, and hope

Stress vs. Burnout (continued) Leads to anxiety

disorders Much of the damage is

physical May cause illness and

premature death

(Hart, A, Stress andBurnout in Ministry)

Leads to detachment and depression

Much of the damage is emotional

May make life seem not worth living

BurnoutAccording to the Texas Medical Association, the

major causes of burnout are bureaucratic atmosphere and overwork

3 Stages of Burnout• Stress arousal (irritability, anxiety increased

blood pressure, etc.)• Energy conservation (excessive lateness,

procrastination, withdrawal, cynicism, etc)• Exhaustion

Compassion Fatigue Compassion fatigue, also known as

secondary or vicarious trauma, involves a gradual lessening of compassion over time. It can happen to individuals who work closely with persons who have experienced trauma. Professionals with a personal history of trauma, especially if it is unresolved, may be particularly vulnerable.

Compassion Fatigue

 Compassion Fatigue can also be described as the emotional residue of exposure to people in pain, particularly those suffering from traumatic events. Helpers who work with such individuals must contend with the normal stress or dissatisfaction of work, as well as their emotional responses to the suffering of those being helped.

Compassion Fatigue

Solutions/Coping Strategies

Helpful activities to promote wellness: Discussing cases with colleagues Talking with colleagues between sessions Attending workshops Limiting case load Receiving clinical supervision Spending time with family and friends

Solutions/Coping Strategies(continued)

Travel, vacations, hobbies, and movies Socializing Exercise Developing a spiritual life

(Pearlman and MacIan, 1995)

Job-Related Skills and Behaviors Prioritize Get Organized Set Boundaries Delegate Where Appropriate Ask for and Accept Help Be Assertive

Job-Related Skills and Behaviors(continued)

Take Breaks During the Day Negotiate for Better Working Conditions Use Your Leave without Apology Commit to Professional Growth

Other Self-Care Suggestions Make Self-Care a Priority Good Nutrition Exercise Rest and Relaxation Address Medical and/or Psychological

Issues Adequate Support—At Work and at Home

Other Self-Care Suggestions(continued)

Set Boundaries Maintain Balance Develop a Positive Attitude Cultivate Compassion for Self Create an Attractive Environment Have Fun Engage in Activities That Feed The Soul

Final Thoughts

In order to assist the helper in functioning at an optimal level again, 3 things are needed:

1. Honesty with Self

2. Personal Responsibility

3. Self-expression

(LaRowe, 2007)