New Curricula Build Resilience in Young Medical Professionals

Maclean’s Magazine recently published an article stating that 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 from 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 AAP 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 curricula 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:  http://www.md.utoronto.ca/Annual_Report/learner-experience/resilience

To learn more about the new “AAP Resilience in the Face of Grief and Loss Curriculum”, please visit: http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/06/peds.2016-0791.full.pdf

Maclean’s article: http://www.macleans.ca/education/new-curriculum-addresses-mental-health-for-young-doctors/

New Course this fall – 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 fall, we are delighted to begin bringing 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.”

 

 

 

 

“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.

 

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“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.

“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.

Q&A: Diana Tikasz on WTF and Other Strategies to Keep You Grounded

On September 30th, Diana Tikasz, MSW, RSW, will be offering WTF and Other Strategies to Keep You Grounded at the Royal Botanical Garden in Burlington, ON. I caught up with Diana last week to ask her about the workshop, her inspiration and what participants could expect from this training day.

Q: What inspired you to develop this workshop?

A: This workshop was developed out of my own personal struggles in my career as well as hearing from numerous workshop participants about similar struggles.  As a trauma therapist in health care settings for the last 26 years, I have experienced numerous WTF moments.  These moments tended to go one of two ways; 1. I would be hijacked by my emotions (usually fear or anxiety) or, 2. I would completely shut down by becoming forgetful, not hearing my clients or just feeling completely numb.  When these moments turned into weeks, I noticed it was incredibly difficult to get through my work day or even engage fully with my family, friends or life in general.   I questioned whether I needed to leave a career that I loved.   It didn’t seem possible to me that I could do my work and also stay emotionally and physically well.

Before taking the drastic step of career change I decided to try to learn to work differently.  My training as a social worker taught me well the techniques to help others; it just didn’t train me on the necessity of applying these techniques to help myself.  This I had to discover on my own.

This workshop is a compilation of some theory but mainly techniques in how to weather the inevitable WTF moments and storms. It is about learning a process that will not only build our resilience, but also our personal growth and enjoyment in our careers.  I have come to view doing helping work as a privilege (mostly) rather than a chore.  Work is not a means to an end but meaningful in and of itself.  We need to enjoy the journey and not just hang in there until retirement.   This workshop is designed to give folks more time to reflect and learn tools that not only help them weather the WTF storms, but also allow them to navigate the ship to be able to enjoy the journey to its fullest.

Q: What kind of skills or strategies will participants gain from attending this workshop?

A: Participants will learn a framework that will help them to continuously self-monitor.  This framework is grounded in neuro-science and will guide us so that we maintain our own emotional well- being.  It’s a framework that guides us to work within our optimal zone and fosters our ability to bounce back quickly after a WTF moment takes us out of that zone.  In this zone we feel calm yet energized, healthy and creative in our work.

The majority of the day will be spent learning and practising various strategies in a detailed way that helps us keep perspective, stay connected and present.  These strategies include:  learning how to quickly tap into our own personal resources as well as develop new ones; utilize tools that that help us self-regulate and recover; methods for gaining and maintaining perspective; skills in being fully present, aware and connected to our compassion.   These techniques will encompass the whole self as I find 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.

Q: Who would most benefit from this workshop?

A: 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.  I often say that helping work is even more difficult when the professional is going through their own personal stresses.   Again, 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.

Thanks, Diana!!

 

How to Outsmart your Negative Brain

CARE4YOU: The Fifth Annual conference on Compassion Fatigue, Secondary Traumatic Stress and Burnout is designed to care for those who care for others. This year, the program was developed around the theme of “Creating Change Agents”. The Conference will be held in Kingston, On. June 9-10, 2015.

This week, we highlight some of our exciting speakers and topics

How to Outsmart your Negative Brain With Daniel Doherty

Do you ever find it challenging to separate your work and personal life?

Helping professionals often feel personally invested in their caring roles – after all, we are caring individuals. There are great rewards for your investment, but there can also be a great personal cost attached to helping others. It can become difficult to separate work from home, and sometimes affects our personal relationships. Our go-to coping mechanism is often detachment from work and home. While we hope to be protecting ourselves, catching our breath, relaxing, and re-charging, the end result of detachment can lead to simply basking in negative thoughts.

Daniel Doherty tackles these issues in his presentation ‘How to Outsmart Your Negative Brain.’ During this session, Daniel will help participants understand the effects of stress hormones adrenaline and cortisol on our limbic system and pre-frontal lobes. Neuropsychologist Rick Hanson, Ph.D., believes the brain has a built in “negativity bias.” Stress often reinforces this negative bias and also diminishes and/or decreases the useful effects of our “happy hormones.” By understanding our brains when they are stressed, we can take advantage of those “happy hormones” oxytocin, dopamine, serotonin, oxygen.

Throw in some jalapeno peppers and 26 seconds to learn how to outsmart the negative intrusive thoughts that keep us in a fatigued state of mind.

Daniel Doherty, MSN, works at Christiana Care Health Systems in Delaware. Christiana Care Health System is one of the country’s largest health care providers that serves more than 600,000 patients yearly; recently Christiana was honored with the Magnet Award status for excellence in nursing by the American Nurses Credentialing Center. For the past 20 years, Daniel has gained experience in emergency nursing and staff development. Daniel has presented similar workshops on this topic to over 100 staff members at Christiana Care Health System and 34 police officers in the Wilmington Delaware Department. Daniel is also a part of the adjunct faculty with Delaware Technical & Community College. Delaware Tech is the State’s first community college, and seeks to inspire their mission of commitment, responsiveness, and vision on a national and state level.

For more information on CARE4YOU click here

Grounding Techniques for the Trauma-Exposed Practitioner

 

This week, we highlight some of our exciting speakers and topics

Emotional Freedom Technique: Creating Personal Change through Tapping With Diana Tikasz, MSW.

Do you ever feel stuck? Do you ever wish things would change, that you could be different? You are not alone. Too often we set resolutions, goals, and personal vows only to slip up and reach for that TV remote, that third chocolate cupcake and that second glass of wine. Making emotional changes is tough; we fall back on old patterns and give up on our goals. But deeper, lasting change is possible…especially if you have fun!

In her session, Diana Tikasz presents a powerful tool for creating personal change. ‘Emotional Freedom Technique’ is a simple acupressure technique that allows us to dig deeper and address the beliefs that can often sabotage our efforts and keep us feeling stuck. EFT has been growing in popularity because the simplicity of the technique can be applied to a wide variety of complex issues.

This workshop will provide hands-on training in the basics of EFT, and highlight emerging research that reveals a direct calming of stress in the body when EFT is applied. Diana will help teach you ways to create deeper emotional change that will stick.  Be prepared to have fun and tap into your “silly side” as you learn this procedure. The session is designed to not only help you create your own personal change, but to also help others realize their goals.

Diana Tikasz, MSW has worked in the teaching and health care sector for the past 27 years.  Her helping work began as an early childhood educator nurturing children and their families to reach their fullest potential. Over the course of her career she has worked in emergency department crisis teams, coordinated hospital based sexual assault/domestic violence treatment programs, which involved assisting individuals experiencing a current crisis, counselling those who have been traumatized by violence, and teaching other professionals how to do this work effectively while staying healthy themselves.  She has also worked in various Employee Assistance Programs and private practise where she has specialized in working with individuals who are feeling stressed by their personal and/or work life. Diana grounds her work in current knowledge of the neuro-biology of stress and trauma and utilizes techniques/strategies that work on rebalancing holistically.  Her passion is to assist people in creating personal, professional, and organizational changes that promote optimal health and make us more effective helpers.

 For more information on CARE4YOU click here