New Curriculum Builds Resilience in Young Medical Professionals

According to a recent article in MacLean’s Magazine, approximately 29% of young doctors experience symptoms of depression or receive a clinical diagnosis. Why? Part of the problem lies in the immense competition young doctors face to obtain jobs. The culture of residency, where young physicians are often required to work excessive hours to stay competitive, is cited as a major source of mental health deterioration. Perhaps most obvious are the stresses associated with making difficult, life-and-death decisions with little to no experience.

Compounded, these issues are causing a mental health crisis among young health-care providers across Canada, and particularly medical students. Lack of sleep, stress and poor self-care contribute to diminishing mental health. Zane Schwartz writes that there is hope: “Young doctors across Canada are trying to change [the] statistics, encouraging struggling peers to seek support and building programs that make it easier for them to take care of themselves…the new curriculum for the University of Toronto, rolling out this fall, which will include several weeks of resiliency training.” Resiliency training is at the forefront of efforts seeking to help future medical professionals cope with the stresses of their work. At UoT, Shayna Kulman-Lipsey, Manager of Counselling has launched a number of initiatives aimed at breaking the stigma attached to seeking help. She argues that the ability to gain resiliency is dependent, in part, on reaching out to peers for support, which can be difficult in an environment that stigmatizes asking for help as a sign of weakness. If medical students develop the skills to maintain resiliency earlier in their careers, they will be better equipped to take on high-stress workplaces and maintain high levels of patient care later.

In the United States, a similar need has been identified by the American Academy of Pediatrics (AAP). This month, the AAP released a special article in Pediatrics, the Official Journal of the AAP titled “The AAP Resilience in the Face of Grief and Loss Curriculum” authored by a group of physicians across the United States. According to the publication, The AAP Section on Medical Students, Residents and Fellowship Trainees identified a need to address the management of grief and loss that health care professionals experience throughout their careers. The development of this new curriculum was endorsed and sponsored by the  AAP Section on Hospice and Palliative Medicine.  A large portion of the new curriculum focuses on the physician-patient and physician-family relationship, with modules designed to help pediatric health-care professionals learn to communicate effectively with children and their parents. The last section of the curriculum, Part D: Introduction to Personal Well-Being, has been developed specifically to address physician well-being. Like the folks at UoT, the authors here argue that teaching medical students personal strategies to cope with stressful events in the workplace will promote long-term well-being and resiliency as their careers progress. The new curriculum recommends a Wellness Learning Plan, that “might be incorporated at the beginning of medical school and reviewed with the student’s advisor or mentor quarterly.” While the AAP publication is specific to the experiences of grief and loss, the message is more broad: resiliency is critical in maintaining personal well-being in high-stress, trauma-exposed workplaces. Educating students early in their careers with these types of curriculum may offer longer-term prevention of burnout, fatigue and secondary traumatic stress.

To read more about programs for medical students at the University of Toronto, please visit:

To learn more about the new “AAP Resilience in the Face of Grief and Loss Curriculum”, please visit:

Maclean’s article:

Restoring Resilience: Mind Body Medicine to Release, Recover, and Revitalize

Resilience is defined as the ability to recover or “bounce back” from a stressful or adverse experience. In this CARE4YOU session, Dr. Shailla Vaidya will help participants review the physiology of stress response and how these responses can contribute to burnout. We will become mindfully aware of where our bodies hold stress and practice gentle, restorative, and breath-focused movement to encourage recovery by relieving pent-up stress. We will explore the wisdom of treating ourselves as well as we treat others in order to open a greater discussion on the role of self-compassion within our personal journeys toward restored resilience.

Shailla Vaidya

Dr. Shailla Vaidya is a Harvard-educated Physician, Mind-Body Medicine for Stress Resilience in Toronto. She has a background in Emergency Medicine, Family Medicine and Health Management. Her clinical interests lie in the ways in which childhood adversity, attachment, and stress can lead to the development of chronic illness. Integrating yoga into her practice, she offers both individual sessions and group workshops to help those suffering from burnout and stress, restore and build resilience. For more information, please visit


WTF: Essential Grounding and Debriefing Tools for Front Line Workers


Become more centered among the chaos

In the course of their work, many helping professionals are regularly exposed to difficult and sometimes traumatic material: anyone working in the criminal justice system, victim services, front line workers, those who work with forensic evidence and child exploitation, first responders, mental health crisis teams, homeless shelter staff and many others.

When there is a lot of exposure the risk for secondary trauma and compassion fatigue are high. How do we remain healthy and balanced while doing this challenging work? We need tools in our toolbox, skills that we can use before, during and after the difficult event has taken place. New research on grounding techniques and trauma reduction skills are showing promising results in helping to reduce secondary traumatic stress in trauma-exposed professionals.

This October, we are delighted to bring to you a brand new workshop designed by our very own Diana Tikasz, MSW, RSW. Diana has worked for many years in high stress, high trauma-exposed work settings and brings to this training her vast experience as a front line worker and supervisor, as well as the newest findings on the neuroscience of trauma exposure management.

WTF isn’t a swear word! It refers to the Window of Tolerance Framework. The WTF is our optimal zone – the place where we do our best work, when we are feeling calm yet energized, healthy and creative. Stressors and triggers can bring us out of that zone into high stress and reactivity, or into numbness and avoidance.

The techniques offered in this workshop will encompass the whole self as we can often retreat and get stuck in our heads. An emphasis will be on learning and incorporating strategies that change the way we work as opposed to using all our personal time to replenish what our work takes out of us.

This session will provide skills to help move yourself out of states of reactivity or avoidance and into the place of possibility to become more centered among the chaos. This is a crucial skill for front-line workers and others working with forensic evidence, investigations, court, witnesses and victims, and those working with individuals who have experienced difficult and traumatic experiences.

Those who would benefit are any folks in a helping profession that feel they are often overly stressed or hijacked by emotion, or those who are no longer enjoying their work and wondering whether they need to make a career change. Helpers who wish to learn specific skills that they can utilize to protect themselves in difficult situations whether it is working with those challenging clients, sitting in a difficult team meeting or interacting with a colleague who pushes your buttons. It is also for those who find that at times their personal lives are creating the WTF moments, which makes it extremely difficult to be present at work.

Diana: “I often say that helping work is even more difficult when the professional is going through their own personal stresses. We will focus on providing a framework and resources to help us navigate the storm. This workshop is especially for those who are feeling completely detached from what they are doing, feeling as though they are just “going through the motions” or counting down the days to retirement.”

Please consider joining us at the Royal Botanical Gardens in Burlington, Ontario on October 20, 2016 or bring this training to your team!

For more information and to register, click HERE.




“Reducing Secondary Trauma in Clinicians: A new approach”

Presented by Brian Miller, Ph.D.

Facing compassion fatigue, burnout and vicarious trauma is challenging. As we raise awareness about self-care techniques, we must also expand our search for strategies that help treat anxiety and trauma into the broader neuroscientific and treatment literature. Here, we find important evidence-informed strategies for influencing the way professionals experience their time with clients, how they think about it, and how to “keep the energy moving” to help professionals be more resilient.

Join Dr. Brian Miller as he presents the CE-CERT model (Components for Enhancing Clinician Experience and Reducing Trauma) model, which is comprised of specific, defined skills to help therapists thrive. Compassion satisfaction occurs when we find our job rewarding even as we are doing it, not when we have sufficiently shielded ourselves from our job. In order to make that goal attainable, we must consciously oversee our affective experience as we work with clients.

Dr Miller will be identify five key clinical practice and supervision skills, and the foundational knowledge of the relevant neuropsychological, social cognitive, anxiety and trauma treatment literature from which they are drawn. These skills include; engaging and “metabolizing” intense affect; skills for decreasing rumination; conscious oversight of narrative; reducing emotional labor, and; parasympathetic recovery. Participants will gain key strategies to positively change their working experience.

Brian Miller is the Director of Children’s Behavioral Health at Primary Children’s Wasatch Campus In Salt Lake City, Utah.  Until recently, he directed the Trauma Program for Families with Young Children at The Children’s Center in Salt Lake City, a community mental health center serving preschool age children and their families. Dr. Miller has worked in a broad variety of treatment and mental health policy settings, including serving as the Salt Lake County Mental Health Director, Clinical Director of Davis Behavioral Health, Associate Director of the Utah State Division of Mental Health, and as a psychotherapist in private practice. He consults with behavioral health agencies on implementation of evidence-based practices, transforming practice to trauma informed care, and organizational supports for secondary traumatic stress in treatment providers. He holds a Ph.D. from Case Western Reserve in Cleveland, Ohio, where he was a Mandel Leadership Fellow. He currently serves as board president for the National Alliance on Mental Illness, Utah Chapter, and on the board of the Polizzi Clinic, a free clinic for behavioral health services in Salt Lake City.


“Grounded-Strategies for Staying Centered Under Pressure”

Working in trauma exposed environments can easily leave us feeling unbalanced.  In this workshop, Diana Tikasz will present a useful model to understand what happens to us internally as helpers throughout the course of our stressful days. The model helps us to continuously self-monitor and recognize when we are off centre.  The model alerts us to the need to re-set ourselves for optimal balance and wellness. Diana will teach strategies that will help you stay grounded and re-establish equilibrium when the stress related to trauma content has knocked you off balance.  She will discuss how to utilize these strategies before, during, and after exposure will be addressed.


Diana Tikasz has been committed to trauma-focused work in the health care sector for the past 20 years. She has coordinated hospital based sexual assault/domestic violence treatment programs, which involved counselling those who have been traumatized by violence, teaching other professionals how to do this work effectively while staying healthy themselves. Diana has also worked in the area of Employee Assistance Program counselling where she has specialized in working with individuals who are feeling stressed by their personal and/or work life. Her passion is to assist people in creating personal changes that promote health. Participation on numerous community and provincial committees, research projects and educational endeavors rounds out her professional interests.



“What is the Cost of Unmanaged Conflict?”

By Meaghan Welfare, BA

Do you experience conflict at work? Are you a leader? Did you know that leaders spend up to 25% of their time dealing with conflict that could be addressed and solved at the source? Unmanaged conflict is costly. It affects the mental health of your people, which results in absenteeism, employee retention issues and a negative institutional reputation.  To attract and retain great employees, organizations must focus on their wellness, beginning with positive and productive relationship management. Meaghan Welfare is an expert in managing conflict within organizations while creating “conflict competence”. Her workshop will equip participants with organizational competencies designed to foster strong working relationships as well as detect and address inevitable workplace conflict.

Meaghan Welfare is a conflict management practitioner with the Department of National Defence at CFB Kingston. She is also a Certified Compassion Fatigue Educator with the Green Cross Academy of Traumatology. She holds a degree in criminology and criminal justice with a minor in law, a graduate certificate in dispute resolution from York University and a certificate in family mediation from University of Waterloo.

“Creating Resilient Teams: Tools for Team Leaders, Managers & Supervisors”

Don’t miss Franҫoise Mathieu’s workshop “Creating Resilient Teams: Tools for Team Leaders, Managers & Supervisors” at the 6th Annual CARE4YOU Conference!

Trauma-exposed work creates a unique climate with increased risk for serious stress and burnout, resulting in sick time, low morale, lack of team cohesion and high turnover. These consequences can seriously limit a team’s ability to work effectively and efficiently. Leaders in high-stress workplaces play a unique role in managing these risks and building resilient teams.

Join Franҫoise Mathieu at our 6th Annual CARE4YOU Conference on Compassion Fatigue to learn more about building resilient staff to promote your organization’s health. This session is designed for managers and supervisors of teams working in high stress, trauma-exposed environments such as healthcare, the criminal justice sector, social and human services, emergency response, armed forces, education, child welfare, community mental health, non-profit organizations and related services. Franҫoise will work with participants to develop strategies that build resiliency, promote team cohesion and create a productive working environment. Attend this session to meet other managers, team leaders and supervisors while gaining tools and resources to promote your organization’s health!

Françoise Mathieu is a sought-after speaker and educator in Canada, the U.S. and around the world. With over 20 years of work in the field of mental health, she brings with her extensive experience as a crisis counselor, and nearly a decade of working with Health Canada’s CFMAP (Canadian Forces Member Assistance Program). Françoise is now Co-Executive Director of TEND, a joint venture with Dr. Pat Fisher and divides her time between public speaking engagements and working with organizations looking to train their teams about burnout, compassion fatigue, vicarious trauma, high stress workplaces, self-care and helper wellness.

Françoise is one of the leaders of Compassion Fatigue and Vicarious Trauma education in Canada. She is the author of The Compassion Fatigue Workbook (Routledge, 2012) and she delivers workshops all over North America.


To Register for the CARE4YOU Conference, click here!

Welcome to TEND !

tend-logo-sm (400x153) (2)

By Françoise Mathieu


Some of you who have been regular readers of the Compassion Fatigue Solutions blog over the years have probably wondered about the lack of blog posts in the past several months. Folks who follow Dr. Patricia Fisher’s website may also be wondering, “hey, what’s going on here – why the new website and new name?” So please allow me to apologize for our prolonged silence and explain what’s been going on. It’s all good, and it’s all very exciting!


Patricia Fisher and I met over a decade ago, and immediately realised that there was a tremendous amount of synergy between our work. Pat, a highly experienced clinical psychologist and long-time trauma specialist, had been hard at work developing cutting edge interventions and resources to help high stress, trauma-exposed organizations better support their teams. I had been consulting, writing and teaching extensively on topics related to compassion fatigue, burnout and secondary trauma, with more of a focus on individual wellness among helping professionals. Pat and I started working together with increasing frequency, and finally decided to combine our expertise and offerings under one umbrella, a joint venture which we call TEND.


We have spent the last year working extremely hard to build a website (which is still under development, but go take a look around!) and pool our resources and services. For us, it’s most definitely a case of “two heads are better than one” and “it’s more fun if we do it together!” We also have the privilege of bringing to this new adventure a stellar team of associates who have worked with us for many years and who also have their own tremendous and unique expertise to share.


In the coming weeks, we will provide blog posts describing a few of our projects, and I will also resume blogging about a variety of current events and resources, as I have in the past. We’ve also become more connected to social media so please check out our Twitter feed and our Facebook page where we post more frequently, often about new resources and events in the news.


Here are some upcoming events and courses that may be of interest to you:


CARE4YOU Conference – June 2, 2016


We’re going on the road this year! Our annual gathering CARE4YOU, the conference for those who care for others, will be offered in Toronto on June 2nd. Click here for more information about our speakers and registration details.


Train the Trainer Booster – June 1, 2016

As we have done in the past few years, we will be offering a Train the Trainer Booster session on June 1st as a preconference event for Compassion Fatigue Educators looking for a tune-up and for new resources.  Please note that this event is limited to 25 participants so please register early to avoid disappointment.


Online courses:


If you are interested in online training, please take a look at the e-learning section in our store. We have web-based courses available on a variety of topics related to individual wellness, compassion fatigue, conflict management and resiliency.


Upcoming workshops:


We have some brand new workshops coming up in the Fall. Stay tuned for that!


Thank you for your patience during our transition time, and welcome to the new blog! We hope that you will come back frequently.


Warm regards,




“Sock Drawer Stories: Portraits of Hope & Healing”

This week on White Coat, Black Art with Dr. Brian Goldstein, Teresa Coulter shares her unique project “Sock Drawer Stories”, inspired by the traumatic stress effects on first responders. Teresa has over 14 years of experience on the front-lines and  “learned to cram away” her traumatic experiences, like many of her colleagues. When she reached her breaking point, Teresa turned to her artistic nature to express her feelings and process her traumatic experiences. She has since helped other first reponders to tell their stories through her painting.

“Over the years, Teresa has had many calls to respond and function in a brutal and horrific setting.  Like many of her colleagues, she learned to cram these experiences away. Her friend, Calgary paramedic Rob Gladney told her he did the same thing — he called it stuffing the bad socks into the back of the sock drawer. Both of them experienced an incident caused the entire sock drawer to spill out, forcing them to confront long-buried feelings.

For Teresa, it triggered a period of introspection and also kindled in her a desire to paint her feelings.  It was then that she got the idea to recruit and paint the portraits of fellow first responders with PTSD.  And Rob’s image of that over-stuffed sock drawer gave the project it’s name. The 12 portraits she painted – men and women from the front lines of health care – form the backbone of an art exhibit entitled Sock Drawer Stories. It garnered rave reviews when it was shown at the University of Calgary in June and has since been shown in Edmonton.” – Dr. Goldstein

Click here to check out this amazing project, listen to the podcast and read Teresa’s story.