Tools to Reduce Vicarious Trauma/ Secondary Trauma and Compassion Fatigue

If you would like more resources after reading this article, please have a look at our online training resources and books.

In a previous post (links here) we discussed some of the warning signs of VT/STS and Compassion Fatigue. We are often asked “what can I do personally and professionally to reduce the negative stress-related effects of my work?” We have many resources to recommend.

First, please have a look at the extensive list of TEND resources further down in the post, or also the wealth of articles we have posted in our resources section from other authors who are specialists in the field. If you are struggling with significant frustration with your workplace and feel that you do not have much control over the system or your job, and don’t feel that you can move to a better employment situation, please start by reading this article:  Beyond Kale and Pedicures

Where to start?

For starters, hopefully you will have read through our other posts to assist you in identifying the main challenges that you are facing: Is it related to too much exposure to difficult stories or a lack of referral resources? Is it work overload or an unsupportive supervisor/toxic team? Are you struggling with difficult personal circumstances that are affecting your ability to manage your stress? Do you feel overwhelmed with your complex case load and feel that you lack training in managing the most difficult and challenging situations? The answers will likely be as varied as there are professions and individuals reading these lines. So where can we start?

I will be honest, we often disappoint people who come to us for sound bites and “quick fixes” to these complex issues because, well, the solutions are complicated, just like the work that we do is multi-faceted and challenging. But here are some places to start:

Recent research in the field of STS and Compassion fatigue suggests that there are particular vulnerability factors that can increase your likelihood of being negatively impacted by the work. Take a look at this Venn Diagram 

Which of these factors are true for you?

Prior Trauma history/vulnerability factors

Do you have your own history of trauma? Are you currently struggling with a difficult family/personal circumstance? Do you have a history of mental illness or addiction that is currently re-emerging? All of these factors can contribute to increased vulnerability when doing high-stress, trauma-exposed work

Traumatic grief/loss in the workplace

Have you experienced losses at work? The death(s) of clients or patients, someone that you worked with who disappeared and never returned, providing you with no closure? A beloved colleague who died unexpectedly or retired or was laid off? The loss of a well-respected supportive supervisor or mentor? Significant changes to your workplace?

Direct exposure

Are you exposed to dangerous situations in your work? Have you ever been threatened, assaulted physically or verbally on the job? Is your work high-risk?

Secondary/Vicarious Trauma

Are you regularly exposed to indirect trauma at work? Hearing/viewing difficult case files, traumatic images and stories?

Compassion Fatigue

Have you experienced a shift in your ability to feel empathy for individuals you work with and/or colleagues or loved ones? Some situations can be very depleting – chronically desperate clients who don’t follow through on your recommendations and keep coming back in distress, a very large homogenous case load where all of the stories start sounding the same, years of exposure to traumatic stories that no longer generate any reaction in you.

Systems Failure

Many professionals describe experiencing moral distress around failures of the system: rules, laws and policies that you disagree with but are still mandated to comply with and that you feel are causing further harm, lack of referral resources and other injustices. All of these can lead to a pervasive feeling of anger and contribute to burnout and workplace toxicity and a decrease in the quality of care provided.

Burnout

Burnout can result from a negative overall workplace experience: your hours, your salary, your workload, the health of your work climate, rewards and recognition, who you immediately report to, the quality of your work relationships with colleagues and a perception of fairness and adequate support to do your job in the best way possible. A negative combination of these factors can lead to burnout.

 What works?

 First, take a look at which elements of the Venn Diagram are most salient for you and begin by addressing those that feel most manageable. As the saying goes “Dig where the ground is soft”. Seek support, formally with a good mental health practitioner or a coach, informally with colleagues and friends, look at ways to reduce trauma exposure in your personal/leisure time. Learn some stress-reduction techniques; get more training in trauma-informed practices which can be highly protective in retaining compassion when working with difficult cases and finally, please be open to the possibility of changing jobs if things are just too challenging where you are now. As Cheryl Richardson says in her book “Take time for your life” (1999) “Do not confuse difficult choices with no choice.” There is too much at stake to ignore compassion fatigue and secondary trauma.


WANT MORE? Here are some TEND resources to explore:

Live Training – bring one of our TEND associates to your organization for specialized training in resilience, compassion fatigue, etc.


Books – we carry 3 wonderful books (and e-books of each) written by our wonderful co-executives Françoise Mathieu and Dr.Patricia Fisher

Building Resilient Teams – a workbook designed as a practical, realistic and effective approach to building team resiliency and cohesion through a sequence of safe and respectful guided discussions.

Resilience Balance and Meaning Workbook – designed to provide you with practical help in addressing the effects of workplace stress, burnout and trauma. You will see that it is designed as a highly interactive tool and you are encouraged to make the book your own by responding to the frequent questions, reflections and self-assessments.

The Compassion Fatigue Workbook – a lifeline for any helping professional facing the physical and emotional exhaustion that can shadow work in the helping professions


Online Courses – TEND also offers online courses at a very affordable price, we do bulk discounts as well for larger groups. These courses are led by Dr.Patricia Fisher and Françoise Mathieu

Organizational Health in Trauma-Exposed Environments: Essentials – an intensive online course 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

Compassion Fatigue 101 Online Course -Three-part webinar series that aims to help participants identify compassion fatigue, vicarious trauma and burnout, and participants will develop self-care strategies.

Resilience in Trauma-Exposed Work – This workshop will provide a solid framework to understand the mechanisms of stress and resilience within trauma-exposed environments, and will introduce practical, best-practices approaches to increasing resilience and enhancing individual wellness and organizational health.


Other Suggested Resources:

Compassion Fatigue/Vicarious Trauma/STS:

The Compassion Fatigue Workbook by Françoise Mathieu 

Trauma Stewardship by Laura Van Dernoot Lipsky

Organizational Stress:

Building Resilient Teams by Dr. Patricia Fisher, R.Psych., L.Psych.

Is work Killing You? A Doctor’s Prescription for Treating Workplace Stress by David Posen

Stress Reduction

Resilience, Balance & Meaning Workbook by Dr. Patricia Fisher, R.Psych., L.Psych.

Grounding Skills

 Graham, L. (2013) Bouncing back: rewiring your brain for maximum happiness. New World Library.

Tools for Managing Trauma:

NakazawaD.J. (2015) Childhood DisruptedHow your Biography Becomes your Biology. Atria.

 Van Der KolkB. (2014) The Body Keeps the ScoreBrainMind and Body in the Healingof TraumaPenguin Books.

ScaerR. (2014) The Body Bears the BurdenTraumaDissociation and Disease. Routledge.

MatéG. (2003When the Body Says No: Exploring the Stress/Disease Connection. Wiley & Sons.

Work/Life Balance:

Richardson, C. (1999) Take Time for Your Lifea 7 Step Program for Creating the Lifeyou Want. Broadway books.

Mindfulness & Selfcompassion websites

www.franticworld.com/free-meditations-from-mindfulness

www.self-compassion.org

www.mindfulselfcompassion.org

Taking It’s Toll…Paying The Price: Vicarious Trauma in Law Enforcement

Law enforcement; a much maligned field but everyday these wonderful individuals knowingly put themselves in to positions of physical danger so that the rest of us can feel safe. While the potential harm to themselves physically is better documented, what are the long term risks of taking a bullet as a police officer, the mental health aspect of their work and who is more likely to end up traumatized by this work is just beginning to be understood. Enjoy this fantastic article by Dr.Fisher below!

By Patricia M. Fisher. Ph.D., & Mark LaLonde
Blue Line Magazine September Issue, 2001

THE SCOPE OF THE PROBLEM

As Tom’s example demonstrates, law enforcement professionals are exposed to two very different sources of stress – organizational (or systemic) job stress, and traumatic stress. Longterm exposure to systemic job stress results in a wide range of negative effects on individuals and the workplace. Exposure to traumatic stress also results in a characteristic set of distressing responses and symptoms. While both systemic stress and traumatic stress are each serious problems in their own right, when combined they greatly increase the risk for negative effects.

It is now clear that the effects of workplace stress and trauma are critical issues in lawenforcement. We know that the problem affects members, their families, the workplace, and the employer. We also know that the problem is increasing and that the personal and financial costs are escalating.

Consequences to the individual member may include a wide range of physical health problems including cardiovascular disease, gastrointestinal problems, increased risk for cancer, and immune system problems. Depression, anxiety, posttraumatic stress disorder, substance abuse and addictions are all outcomes of long-term high-level workplace stress. Unfortunately, longterm stress symptoms such as poor communication, withdrawal, aggression, mistrust and defensiveness often contribute to family breakdown and loss of the member’s support network.
In terms of the organization, effects include decreased productivity, poor morale, increased staff conflict, absenteeism, increased overwork and overtime. Stressed members are also at risk to “cut corners” and engage in more hazardous practices.

Read More Here

A Comprehensive Approach to Workplace Stress & Trauma in Fire-Fighting

An academic article by our very own Pat Fisher.

Do you have any firefighters in your lives that you know could use this information? Please share.

Excerpt: “Firefighters are exposed to a wide range of workplace stresses resulting in a wide range of negative physical, psychological, interpersonal and organizational consequences. This paper presents a comprehensive approach to workplace stress in fire-fighting. The Complex Stress Model encompasses the full set of workplace systemic and traumatic stresses encountered by firefighters. The risk/resilience factors, effects and outcomes of systemic and traumatic stress are reviewed, followed by a discussion of the challenges these pose to fire-fighting organizations. Within this framework, effective workplace wellness and organizational health initiatives need to incorporate three strategic elements: building capacity, increasing resiliency, and supporting positive culture change.”

Read the full article here.

Addressing Workplace Stress: A Comprehensive Wellness Imperative for Individuals and Their Organizations

Click here for the pdf.

HUFFPOST, THE BLOG 07/02/2013 06:45 pm ET | Updated Sep 01, 2013 Addressing Workplace Stress: A Comprehensive Wellness Imperative for Individuals and Their Organizations By Patricia Fisher, Megan Cleghorn • • Identifying the most pronounced sources of stress in your life is rarely difficult. However, pinpointing some of the less overt stress triggers is more challenging. Understanding how multiple sources of stress in your life act in concert to create your own individualized risk and resiliency profile is even more complex.

One thing we know with certainty is that your health and wellness cannot be compartmentalized. No area of your life is exempt from impact if one or more other areas of your life are burdened with high stress. Similarly, just as no discrete part of your life is singularly impacted by high-stress exposure, you are not the only one impacted. Your stress level has many consequences for your organization’s health that manifest in terms of direct and indirect costs as well as detrimental effects on the work environment. As a result, your organization has a vested interest in your ability to effectively address stress and burnout, because your wellness drives your organization’s performance. Accordingly, creation of a robust organizational wellness infrastructure and implementation of research and experience based stress-management programs should be embraced as a central operational priority.

A comprehensive approach to stress management requires a thorough understanding of the many sources of stress in your life as well an appreciation of all the sources of support and resilience. This provides a balanced framework to examine the wide-ranging impacts of stress on your physical and mental health, your professional and personal relationships, and your overall capacity to function optimally. Gaining an accurate understanding and awareness of your stress profile supports meaningful actions and the development of a comprehensive wellness plan that will reduce the negative impacts of stress on your mind, body, relationships and performance. Consider the following integral steps to raising awareness and spurring meaningful progress :

2

What Does My Risk Profile Look Like?

Gaining an accurate awareness of your stress risk and resiliency profile in your professional and personal life is an important initial step toward enhanced wellness. There will be factors that are supportive and resiliencebuilding and other factors that increase your experienced stress. With respect to your professional life, for example, consider factors such as workload, level of control, job demands, role ambiguity, and compensation and advancement opportunities. Also consider your individual risk factors such as work/family conflict, and your belief in the value of your work. Consider the same in your personal life. This analysis helps you determine how at risk you are to develop stress and trauma symptoms.

How Well Am I Taking Care Of Myself?

Our bodies and minds are not designed to sustain consistent exposure to high levels of chronic stress. Evaluate what you are currently doing to manage your stress professionally and personally. Take a holistic approach to your selfassessment because a balanced lifestyle is central to effective self-care. Often we find that our self-care may be quite good in some areas of our lives and neglected in others. The more balanced we are, the more we are able to cope with the stresses and demands that we face. Unfortunately, many of us find ourselves caught in a tornado of work, family responsibilities, household tasks, and other personal obligations. Life can then become a succession of stressful events, deadlines and obligations, leaving little opportunity for renewal or even for simple pleasures. Consider what steps you are currently taking to manage your self-care physically, psychologically and emotionally, cognitively, behaviorally, interpersonally and spiritually.

What Is My Stress Symptom Profile?

We know that chronic stress plays a central role in the development of stressrelated physical and mental health challenges, cognitive functioning, professional and personal relationships, and the ability to see life with optimism, hope and energy. Once you have established your risk and resiliency profile and your self-care profile, consider your individual profile of stress symptoms and effects, focusing on physical health challenges such as stress-related illness and disease, and mental health consequences such as depression, anxiety disorders, and substance abuse. It is also essential to probe the specific symptoms you experience relating to job stress, burnout, harassment, and exposure to direct and vicarious trauma.
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Where Do I Go From Here?

In moving from awareness to action, it is essential that you acknowledge and accept the magnitude of your stress symptoms and commit to developing an active and practical wellness plan. That wellness plan should be constructed to allow you to recover from any existing stress effects, to then maintain a level of self-care that matches the level of demands placed on you, and to engage in proactive practices to increase your resilience. Ultimately, to succeed in enhancing your individual wellness and, in turn, your organization’s health, you must build a comprehensive lifestyle that supports and sustains you through work and personal stresses. Sustainability rests on the principle that you have to replace that which has been depleted. If you are going to be a productive, active, effective person and teammate, you need to be well-nourished at all levels. To make durable changes in your professional and personal life, you and your key stakeholders must partner in (1) making a serious commitment to address the impact of stress in your lives, (2) taking responsibility for what you choose to do about your stress-management, and (3) taking action from an attitude of care, concern and respect. We need to clearly understand that for both individuals and organizations to flourish, we must treat our individual and collective wellness as a central operational imperative.

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.”

 

 

 

 

Beyond Kale and Pedicures…What works to manage compassion fatigue?

Every day this week, we are sharing with you some highlights of the upcoming Compassion Fatigue Care4You Conference June 3-4th, 2014.

The conference will open with a presentation called Beyond Kale and Pedicures….What Works to Manage Compassion Fatigue? with Françoise Mathieu, M.Ed, CCC. Compassion Fatigue Specialist and author of “The Compassion Fatigue Workbook”

Since the mid 1990s, an entire new industry of wellness has emerged: workshops, books, retreats and videos, all aiming to assist professional caregivers and other helping professionals reduce compassion fatigue and vicarious trauma. Many workplaces jumped on the bandwagon early and started encouraging self-help strategies in their staff. Human resource departments began running workshops for staff on healthy eating, work-life balance and “stress busting”. Some organizations implemented regular fitness breaks and staff appreciation days.

Sounds great, right? The problem is that it didn’t really work – many staff stayed away, rates of burnout did not decrease significantly and staff morale continued its downward spiral. To be fair, it made sense for workplaces to focus on self-care – it was inexpensive, easily implemented and it didn’t require major systemic change. It was something concrete they could do. But maybe the solution to compassion fatigue and burnout is a little more complicated…

This presentation will discuss new research which suggests that in order to reduce compassion fatigue and burnout, we need to adopt a multi-pronged approach. Helpers, on their own, cannot be expected to fix an entire system. They do however remain responsible for their own well-being – it is an ethical responsibility, for themselves, their clients and the community in which they live.

So, how do we make this work? Join us for an exploration of where we are at, 20 years after the birth of this field.

Click here for more information

Work life balance: A load of bunk?

Happy New Year dear readers!

To say that I have been incredibly busy during the past six months is pretty much the understatement of 2013. Since July, I have worked with folks from L.A. County Courts, cancer care workers in Bermuda, amazing trauma therapists in New Haven, visited Vancouver three times to present to ObGyns and refugee protection staff (not at the same time…)

I also met staff from the UNHCR, presented at a children’s hospital in San Diego and had incredible learning experiences with fantastic helping professionals at Mount Sinai hospital in Toronto.  My wonderful team of associates have also been busy, travelling to Indiana, Newfoundland and also offering a lot of training right here at home in Ontario. We presented on compassion fatigue, secondary and vicarious trauma, self care, conflict, change leadership, and developed a brand new training on rendering bench decisions to refugee claimants.

I also had the chance to co-develop a new workshop with my friend and colleague Leslie Anne Ross, from the Children’s Institute in Los Angeles, called “a Roadmap for Change Agents.” We are firm believers that the best way to promote healthy workplaces is to encourage the emergence of champions in each agency. This was an opportunity to share best practice ideas with folks from various child welfare departments in L.A. County, and encourage them to spread the learning about healthy workplaces.

Yes, it’s been nuts. But it has also been the most professionally rewarding year of my career. I would like to highlight some personal and professional learnings from the past year and see if some of them resonate for you: Read More

Trauma Sensitive Yoga for Soldiers and Veterans

 

I worked as a mental health counsellor for a Canadian military base for about a decade. During this time, I saw many soldiers with PTSD – infantrymen, pilots, intelligence officers and other trades, all of whom had been exposed to unspeakable horrors in war-torn countries such as Rwanda, Afghanistan and Bosnia. Many of them struggled with nightmares, anxiety, intrusive thoughts and reintegration into the civilian world. Some treatment modalities helped, some did not. At some point, a new military psychiatrist came into town, and all of a sudden I started hearing of clients being referred to hot yoga and mindfulness meditation (MBSR) classes. This, in the early 2000s, was very unusual in our neck of the woods. Read More

Making Workplace Conflict Work for You: Three Key Strategies

By Meaghan Welfare, Conflict Management Practitioner

In today’s workplace we can be certain of only three things: there will be change, there will be stress and there will be conflict. It’s inevitable. As we navigate through our work days, we are confronted with conflict on different scales: perhaps someone drank the last cup of coffee and didn’t make more, maybe someone jammed the photocopier and walked away, or maybe you are experiencing bullying and harassment. The fact of the matter is that conflict has an ubiquitous influence on our working relationships. A recent survey conducted by CPP Global found that employees spend an average of 2.8 to 3.3 hours a week dealing with conflict, (low level and un-escalated conflict) and human resource workers spend upwards of 51% of their week addressing conflicts. A 1996 study demonstrated that 42% of a manager’s time is spent on conflict-related negotiations.

So, the million dollar question…What can we do about this?  While conflict is never truly preventable, we can learn effective approaches for maximizing positive outcomes and harnessing conflict to make it work for us.

Read More

How will you navigate the changing landscape of your work?

Has your work changed?

Is there more stress and uncertainty in your job than there used to be?

 

57% of Canadians report high levels of stress

 1/3 Canadians put work first and let it interfere with family

(Duxbury & Higgins, 2012)

 

In 1991, according to the Duxbury study on work-life balance, 46% of Canadians reported being satisfied with life. In 2012, it has plummeted to 23%. As many of you know first-hand, the recent economic downturn has led to significant budgetary compressions in the public purse. As a result, many of us working in the helping fields and in the civil service have experienced massive changes: layoffs, reorganizations, job abolitions, changes in mandate, elevated conflict and a lot of uncertainty and fear of what is yet to come. Over the past ten years, I have crisscrossed the country many times to offer compassion fatigue training in nearly every province and territory. During my workshops, I get to meet with public sector employees, health care workers and other helping professionals as well as with management and human resources. Lately, I have been hearing the same words from nearly everyone I meet:  “change”,  “stress”, “conflict”, “uncertainty” and “overload”.

Is this true for you as well?

Read More