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
Welcome! Introductions
Outline Terminology Effects of Toxic Stressors Ethical Aspects Interventions Self Care Exercise Q & A
Terminology What is Burnout? What Constitute Compassion Fatigue? What is Consider Vicarious Trauma?
Terminology Burnout Compassion Fatigue The Three Toxic Stressors Vicarious Trauma
Burnout Internal psychological experience Emotional exhaustion Physical exhaustion Spiritual exhaustion Attitude and behavioral exhaustion 6 (Paine as cited in James & Gilliland, 2013).
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)
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)
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)
Discussion In your opinion, how do counselors deal with: Boundaries Balancing life & work Self-Awareness Self-Care Others? 10
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).
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).
Ethical Standards of Self-Care 13 Standards of Self-Care Standards of Humane Practice of Self-Care Commitment to Self-Care (SAMHSA, 2014).
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?
Dealing with Burnout, Compassion Fatigue, & Vicarious Trauma The "Three R" approach: Recognize- Identify Warning Signs Reverse- Undo The Damage Resilience- Develop Fortitude
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.
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.
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!
Reflection You, Yourself, As Much As Anybody In The Entire Universe, Deserve Your Love & Affection. ~ Buddha
Self Care Exercise 20 https://www.youtube.com/watch?v=-swnewps_fa
Q & A Any questions?
Resources for Counselors http://ct.counseling.org/2011/01/taking-care-of-yourself-as-a-counselor/ http://www.nadta.org/membership/selfcare-for-therapists.html http://www.counselingpsychology.org/self-care http://psychcentral.com/lib/how-clinicians-practice-self-care-9-tips-for-readers/
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