Warning signs of Vicarious Trauma/Secondary Traumatic Stress and Compassion Fatigue

 

 Adapted from “The Compassion Fatigue Workbook

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

We also have a more detailed example of Signs and Symptoms here.

Learning to recognise one’s own warning signs of compassion fatigue (CF) and vicarious/secondary trauma (VT/STS) serves a two-fold purpose:

First, it can serve as an important check-in process for someone who has been feeling unhappy and dissatisfied, but did not have the words to explain what was happening to them. Secondly, developing a warning system allows you to track your levels of emotional and physical depletion. It also offers you tools and strategies that you can implement right away.

Let me give you an example of what a warning system may look like:

Say, for example, that you were to learn to identify your CF/STS symptoms on a scale of 1 to 10 (10 being the worst you have ever felt about your work/compassion/energy, and 1 being the best that you have ever felt).

Then, you learn to identify what an 8 or a 9 looks like for you i.e. “when I’m getting up to an 8, I notice it because I don’t return phone calls, think about calling in sick a lot and can’t watch any violence on TV” or “I know that I’m moving towards a 7 when I turn down my best friend’s invitation to go out for dinner because I’m too drained to talk to someone else, and when I stop exercising.”

Being able to recognize that your level of CF/STS is creeping up to the red zone is the most effective way to implement strategies immediately before things get worse.

But look back to what also emerges in this process: you are starting to identify the solutions to your depletion.

If I know that I am getting close to an 8, I may not take on new clients with a trauma history, I may take a day off a week, or I may return to see my own therapist.

In order for you to develop your warning scale, you need to develop an understanding and an increased awareness of your own symptoms of compassion fatigue and vicarious trauma/STS.

For a more complete list of Warning Signs, have a look at the Compassion Fatigue Workbook or Compassion Fatigue 101 Course.

In their book Transforming the Pain, Saakvitne and Pearlman (1996) have suggested that we look at symptoms on three levels: physical, behavioural and psychological/emotional. As you will see, there is often overlap between these categories.

Please take a look at the list below and notice which ones are your most frequent warning signs:

Physical Warning Signs (More detail available in extra information post)

  • Exhaustion
  • Insomnia
  • Headaches
  • Increased susceptibility to illness
  • Sore back and neck
  • Irritable bowel, GI distress
  • Rashes, breakouts
  • Grinding your teeth at night
  • Heart palpitations
  • Hypochondria

Behavioural Signs (More detail available in extra information post)

            Increased use of alcohol and drugs

  • Anger and Irritability at home and/or at work
  • Avoidance of clients/patients
  • Watching excessive amounts of TV/Netflix at night
  • Consuming high trauma media as entertainment
  • Not returning phone calls at work and/or at home
  • Avoiding colleagues and staff gatherings
  • Avoiding social events
  • Impaired ability to make decisions
  • Feeling helpless when hearing a difficult client story
  • Impostor syndrome – feeling unskilled in your job
  • Problems in personal relationships
  • Difficulty with sex and intimacy due to trauma exposure at work
  • Thinking about quitting your job (not always a bad idea by the way!)
  • Compromised care for clients/patients
  • Engaging in frequent negative gossip/venting at work
  • Impaired appetite or binge eating

Emotional/Psychological Signs (More detail available in extra information post)

  • Emotional exhaustion
    Negative self-image
    Depression
  • Increased anxiety
    •Difficulty sleeping
  • Impaired appetite or binge eating
  • Feelings of hopelessness
  • Guilt
  • Suicidal thoughts*
  • Reduced ability to feel sympathy and empathy towards clients or family/friends
    •Cynicism at work
  • Anger at work
    •Resentment of demands being put on you at work and/or at home
    •Dread of working with certain clients/patients/certain case files
    •Diminished sense of enjoyment/career(i.e., low compassion satisfaction)
  • Depersonalization – spacing out during work or the drive home
  • Disruption of world view/heightened anxiety or irrational fears
    •Intrusive imagery (You can read an excellent description of this in Eric Gentry’s Crucible of Transformation article).
  • Hypersensitivity to emotionally charged stimuli
    Insensitivity to emotional material/numbing
    Difficulty separating personal and professional lives
    Failure to nurture and develop non-work related aspects of life

Take Stock:

Once you have read through and circled your most frequent warning signs, try and identify your top three most frequent warning signs. I call them the “big three”. Are they all physical, emotional or behavioural or do you see a mixture of signs from each category? Would you say that you are currently in the Green (healthy), Yellow (warning sign) or Red zone with your overall functioning?

Now, ask a loved one or close colleague to share with you what they think your “Big Three” warning signs are, at home and at work.

Next Steps:  

Each warning sign has specific tools that can help reduce your levels of stress. For example, if you are experiencing a lot of secondary exposure-related symptoms, you may wish to examine your caseload, the availability of debriefing and grounding strategies and you may need to assess the level of extraneous trauma images and stories that you are exposing yourself to in your personal life. If you have a lot of emotional symptoms, you may want to consider a consultation with a well-trained mental health professional who is familiar with vicarious trauma and the nature of the work that you do.

In our post on Tools and Resources (link here) we will provide some more suggestions.

*Suicidal or hopeless thoughts? Get Help Now Please remember that no matter how stressful/traumatic our work is, it is not a normal consequence of VT/STS to experience suicidal thoughts or prolonged bouts of depression or hopelessness. Please seek help as soon as you notice these symptoms in yourself. If you are worried about confidentiality, or unsure where to turn, please consult online sources of support. There are urgent suicide support hotlines available 24/7 which you can find with a click of the web. Don’t suffer alone. Get help. You deserve it and so do the people who love you.

 

Sources:

Figley, C.R. (Ed). (1995) Compassion Fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner/Mazel.

Figley, C.R. (Ed.). (2002) Treating Compassion Fatigue, New York: Brunner/Routledge.

Gentry, E. J., (2002) Compassion Fatigue: A Crucible of Transformation in Journal of Trauma Practice, Vol 1. No. 3/4. pp.37-61.

Killian, K. (2008). Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self care in clinicians working with trauma survivors in Traumatology, (14, 2) 32-44.

Mathieu, F (2012) The Compassion Fatigue Workbook – New Revised and Expanded Edition

Van Dernoot Lipsky, L. (2009) Trauma Stewardship: A guide to caring for self while caring for others. BK Publishers.

Saakvitne, K.W.; Pearlman, L. A., & the Staff of the Traumatic Stress Institute (1996): Transforming the pain: A workbook on vicarious traumatization. New York: W.W. Norton.

 

© Françoise Mathieu 2017

 

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.
3

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.

The Future of Compassion Fatigue Education: Working Partnerships with Mental Health Professionals

*Reprinted with Permission

The concept of compassion fatigue (CF) has received increased attention in the animal care and welfare professions in recent years. This is a positive trend. Today, thanks to courses such as IAABC’s Animal Behavior Consulting: Principles & Practice, which contains a full module on compassion fatigue, people who work with animals are better able to access resources informing them that they are not alone in feeling depleted or altered by their work as caregivers for people and pets who are stressed, traumatized, sick, and in need of compassionate services.

However, as interest in compassion fatigue continues to grow, it’s important to be mindful of the quality of the resources being created to meet the increasing demand for compassion fatigue education. Just like dog training, compassion fatigue education is an unregulated industry. Anyone can advertise themselves as a compassion fatigue educator; there are no regulations or standardized training programs for this field. A variety of organizations do offer certificates programs for individuals who wish to become compassion fatigue educators. However, this process varies widely from one certifying organization to another, with some training programs being far more in-depth than others.

These certificates can be a good starting point for anyone interested in deepening their understanding of compassion fatigue, particularly management and leadership who wish to become better informed in order to support their staff and volunteers. But for those who intend to pursue a part- or full-time career in the compassion fatigue education field, the certification process alone will likely not be in-depth enough training to adequately build competency in safely engaging other people in this highly emotional, complex work.

Like their counterparts in professional dog training, professional compassion fatigue educators should demonstrate a commitment to ongoing education, support from other professionals, and clearly communicated boundaries that recognize the limitations of their skills and role.

Read the full article below:

The Future of Compassion Fatigue Education: Working Partnerships with Mental Health Professionals

“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.

 

Beyond Kale and Pedicures – Part Five

Part Five: This isn’t About Perfection

To download the complete article, Click here

By Françoise Mathieu, M.Ed., CCC.

Mount Sinai: A Success Story and a Work in Progress

Nestled between several much larger health care facilities, Mount Sinai hospital is a 450-bed acute care teaching institution located in the heart of Toronto’s downtown. Like many Jewish hospitals in North America, Sinai was originally created nearly one hundred years ago in response to anti-Semitic discrimination and a lack of services for Jews and other vulnerable groups. Since its inception, Mount Sinai has aimed to stay true to its heritage of offering care to those who need it most, and filling a void for those who have nowhere else to turn. This philosophy has also influenced their approach to staff well-being. Sinai has high rates of employee engagement, and a leadership structure that believes in a culture of employee health at all levels, from the cleaning staff to the CEO. The hospital has developed a series of programs and initiatives such as a stress resiliency course called the “Stress Vaccine”, an online module that is now available to health-care workers worldwide. The hospital has a poet in residence, an active wellness committee, and many initiatives aiming to turn Sinai into a magnet hospital for new staff. They also have a commitment to reviewing the efficacy of their programs regularly, based on employee feedback. Read More

Beyond Kale and Pedicures – Part Four

Part Four: Where are we headed? 

By Françoise Mathieu, M.Ed., CCC.

It turns out that wellness practices are probably a great idea for everyone – therapists, circus acrobats and accountants alike. During the past year, I had to research and write this lengthy piece while juggling a busy work and family schedule. I am a writer, a consultant, keynote speaker, business owner and a parent. I travel extensively and have a heavy workload. And so, to cope with this busy time I made sure to exercise daily, practiced yoga several times a week, meditated, ate greens, drank lots of water, avoided excess alcohol and caffeine, tried to get enough sleep, connect with others and have some leisure time. I find that these practices are essential to my well-being. Sure, I can go a few days without them, but I start feeling unwell fairly quickly and that would also be true for many of my overextended civilian friends. Self-care and work-life balance are wonderful tools to manage the pressures of life, and perhaps live a little longer, and it is likely that they are particularly important for those of us who work in high stress, high trauma settings, but it is now clear that these strategies alone cannot compensate for unsustainable caseloads, excessive trauma exposure, toxic work environments and lack of training.

After seven years working as a crisis counsellor in a busy clinic, I quit. Read More