Because I Care: Preventing and Dealing with Burnout, Compassion Fatigue, and Vicarious Trauma

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1 Because I Care: Preventing and Dealing with Burnout, Compassion Fatigue, and Vicarious Trauma Presented by, Noé Vargas DBH, LPC, FT & Patrice Pooler MA, ADC At the Association for Addiction Professionals (NAADAC) Annual Conference Minneapolis, MN October 08, 2016 Phoenix Arizona

2 Welcome! Introductions

3 Outline Terminology Effects of Toxic Stressors Ethical Aspects Interventions Self Care Exercise Q & A

4 Terminology What is Burnout? What Constitute Compassion Fatigue? What is Consider Vicarious Trauma?

5 Terminology Burnout Compassion Fatigue The Three Toxic Stressors Vicarious Trauma

6 Burnout Internal psychological experience Emotional exhaustion Physical exhaustion Spiritual exhaustion Attitude and behavioral exhaustion 6 (Paine as cited in James & Gilliland, 2013).

7 Compassion Fatigue A state of detachment 7 A state of isolation A state of extreme tension Physical and emotional related symptoms Wanting to help, but have not energy to continue (Lee, McCarthy-Veach, MacFarlane & Leroy, 2015)

8 Vicarious Trauma A process that could affect professionals working with trauma victims. 8 It is also called secondary trauma. Different, but similar to, burnout and compassion fatigue. It can change the psychological, physical, and overall wellbeing of the professional. (Pearlman & McKay, 2008)

9 Effects of the Three Toxic Stressors Dimishes patient/client care 9 Reduces job satisfaction High job turnover Lack of energy and hope (Lee, McCarthy-Veach, MacFarlane & Leroy, 2015)

10 Discussion In your opinion, how do counselors deal with: Boundaries Balancing life & work Self-Awareness Self-Care Others? 10

11 Boundaries as a Protective Factor B o u n d a r i e s c o u n s e l o r s s h o u l d u s e c a r e w i t h s e l f - d i s c l o s u r e o r a n y b e h a v i o r s t h a t m a y b e e x p e r i e n c e d a s i n t r u s i v e b y t h e c l i e n t, i n c l u d i n g : 11 P e r s o n a l d i s c l o s u r e s m a d e f o r t h e c o u n s e l o r s o w n g r a t i f i c a t i o n. S e x u a l i z e d b e h a v i o r w i t h t h e c l i e n t. E x c e s s i v e l y i n t r u s i v e q u e s t i o n s o r s t a t e m e n t s. I n t e r r u p t i n g t h e c l i e n t f r e q u e n t l y. V i o l a t i n g t h e c l i e n t s p e r s o n a l s p a c e. I n t e r p e r s o n a l t o u c h, w h i c h m i g h t a c t i v a t e i n t r u s i v e m e m o r i e s o r d i s s o c i a t i v e r e a c t i o n s o r b e e x p e r i e n c e d a s a b o u n d a r y v i o l a t i o n b y t h e c l i e n t. B e i n g c o n s i s t e n t l y l a t e f o r a p p o i n t m e n t s o r a l l o w i n g o u t s i d e i n f l u e n c e s ( s u c h a s t e l e p h o n e c a l l s ) t o i n t e r r u p t t h e c l i e n t s t i m e i n a c o u n s e l i n g s e s s i o n. (Green Cross Academy of Traumatology as cited in SAMHSA, 2014, P. 189).

12 Ethical Aspect of Self- Care 12 C. 2. G. I M P A I R M E N T C O U N S E L O R S M O N I T O R T H E M S E L V E S F O R S I G N S O F I M P A I R M E N T F R O M T H E I R O W N P H Y S I C A L, M E N T A L, O R E M O T I O N A L P R O B L E M S A N D R E F R A I N F R O M O F F E R I N G O R P R O V I D I N G P R O F E S S I O N A L S E R V I C E S W H E N I M P A I R E D. T H E Y S E E K A S S I S T A N C E F O R P R O B L E M S T H A T R E A C H T H E L E V E L O F P R O F E S S I O N A L I M P A I R M E N T, A N D, I F N E C E S S A R Y, T H E Y L I M I T, S U S P E N D, O R T E R M I N A T E T H E I R P R O F E S S I O N A L R E S P O N S I B I L I T I E S U N T I L I T I S D E T E R M I N E D T H A T T H E Y M A Y S A F E L Y R E S U M E T H E I R W O R K. C O U N S E L O R S A S S I S T C O L L E A G U E S O R S U P E R V I S O R S I N R E C O G N I Z I N G T H E I R O W N P R O F E S S I O N A L I M P A I R M E N T A N D P R O V I D E C O N S U L T A T I O N A N D A S S I S T A N C E W H E N W A R R A N T E D W I T H C O L L E A G U E S O R S U P E R V I S O R S S H O W I N G S I G N S O F I M P A I R M E N T A N D I N T E R V E N E A S A P P R O P R I A T E American Counseling Association, 2014, P. 9).

13 Ethical Standards of Self-Care 13 Standards of Self-Care Standards of Humane Practice of Self-Care Commitment to Self-Care (SAMHSA, 2014).

14 Discussion 14 In your opinion, what is the impact on clients when a counselor is impaired, yet continues to practice? What is the ethical obligation of peers when they are aware of a practicing counselor who is impaired?

15 Dealing with Burnout, Compassion Fatigue, & Vicarious Trauma The "Three R" approach: Recognize- Identify Warning Signs Reverse- Undo The Damage Resilience- Develop Fortitude

16 Recognize - watch for warning signs: Physical: Increased exhaustion (tired even after resting); Increased physical ailments (headaches, backaches, illness); Insomnia. Emotional: Increased levels of Anger, Cynicism, Irritability, Resentment. Disconnect from Body/Emotions; Increased guilt; Increased feelings of "not good enough ; Feeling helpless / hopeless towards future. Thoughts: Lack of empathy towards a situation; Questioning abilities / impact; Rigid thinking; Jumping to conclusions; Intrusive images/thoughts related to the trauma. Behavioral: Increased absenteeism; Positive activities are now dreaded; Avoiding relationships, responsibilities & work; Increased behaviors of escape (food, substance abuse, caffeine, nicotine, shopping, TV viewing). Relational: Lack of separation between personal & professional time- always the helper in these roles; reduced personal life not connected to work; Increased isolation unless connected with work/profession; Hypervigilance with others safety.

17 Reverse : Undo The Damage Stress Management: Breathing, Exercising, Walking, Journaling; Reading; Spend time in nature. Develop & Utilize An External Support System: Engage Socially: Reach out to a colleague Have lunch with a friend. Connect with the people you love, that love you Friends & Family are important during difficulties Attend a conference. Therapy- Sometimes Therapist Need Therapists Wounded Healers vs. Healing Wounded.

18 Resilience- Developing Fortitude Resilience Integrating Physical, Emotional & Spiritual Well Being: Physical: Eat healthy. Drink plenty of water. Get Enough Sleep (minimum 6 hours). Exercise regularly. Essential Oils. Emotional: Learn to set boundaries don t over extend yourself - say "No. Journal. Nurture your creative spirit - fun activities that have nothing to do with work. Unplug from technology for a little while. Bubbles. Coloring. Essential Oils. Take a vacation or staycation. Seek joy. Spiritual: Meditate. Mindfulness. Yoga. Explore nature. Inspirational readings. Create a "sacred space" in your home. MAKE A COMMITMENT TO YOUR OWN WHOLENESS!

19 Reflection You, Yourself, As Much As Anybody In The Entire Universe, Deserve Your Love & Affection. ~ Buddha

20 Self Care Exercise 20

21 Q & A Any questions?

22 Resources for Counselors

23 References A m e r i c a n C o u n s e l i n g A s s o c i a t i o n ( ). A C A C o d e o f E t h i c s. A l e x a n d r i a, V A : A u t h o r. J a m e s, R. K., & G i l l i l a n d B. E. ( ). C r i s i s i n t e r v e n t i o n s t r a t e g i e s. B e l m o n t, C A : B r o o k s / C o l e. L e e, W., V e a c h, P. M., M a c f a r l a n e, I. M., & L e r o y B. S. ( ). W h o i s a t r i s k f o r c o m p a s s i o n f a t i g u e? A n i n v e s t i g a t i o n o f g e n e r i c c o u n s e l o r d e m o g r a p h i c, a n x i e t y, c o m p a s s i o n s a t i s f a c t i o n, a n d b u r n o u t. J G e n e r C o u n s e l, 2 4 : d o i : / s P e a r l m a n, L. A., & M c K a y L. ( ) V i c a r i o u s t r a u m a. H e a d i n g t o n I n s t i t u t e, 1-2. S u b s t a n c e A b u s e a n d M e n t a l H e a l t h S e r v i c e s A d m i n i s t r a t i o n. T r a u m a - I n f o r m e d C a r e i n B e h a v i o r a l H e a l t h S e r v i c e s : T r e a t m e n t I m p r o v e m e n t P r o t o c o l ( T I P ) S e r i e s 5 7. H H S P u b l i c a t i o n N o. ( S M A ) R o c k v i l l e, M D : S u b s t a n c e A b u s e a n d M e n t a l H e a l t h S e r v i c e s A d m i n i s t r a t i o n,

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