Leaders Are People Too: Staying Well During COVID-19 – an interview with Dr. Patricia Fisher

Dr. Patricia Fisher, co-founder and Senior Advisor with TEND, is a clinical psychologist and specialist in organizational health and workplace wellness in trauma-exposed workplaces.

In this interview, Dr. Fisher shares best practice recommendations for leaders amidst the stress of the COVID-19 pandemic.

Free Resource: Self-Care Questionnaires from the Resilience, Balance & Meaning workbook

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Q: Dr. Fisher, you have been an expert in organizational health for many years, with a particular focus on professionals who work in health care, corrections, law enforcement and social services.  How did you become interested in working with high stress, trauma-exposed professionals?

A: Like many of us in this field, I had intense personal experience as a clinical psychologist working with high-stress, high-trauma client groups within highly challenged systems and institutions (e.g. mental health, social services, justice system, etc.).

And this is going back to the late 70’s, before we had much language or knowledge around the effects of this kind of work on individuals and systems.

By the late 80’s and early 90’s, we had a much better handle on trauma as it pertained to victims – but we were starting to see serious challenges arising for the frontline trauma workers and their organizations. At the same time, it was becoming clear that frontline workers were providing critical, life-changing services to the client groups.

So, we had a double bind: there was a growing need for services but at the same time, the workforce and their organizations were losing capacity and, in a sense, victimizing their workers.

Fortunately, pioneering work by Pearlman, Saakvitne, Finklehor and others was looking at the impact of trauma work on practitioners and starting to propose ways of addressing it. In the mid-90’s, I began to look at the risk and resilience factors at play for practitioners working in trauma-exposed environments within highly pressured and constrained organizations. This was the basis of my Complex Stress Model as well as the research, trainings and interventions that were built on it.

Trauma-exposed workers and their organizations provide services that are vital for a civil society. It is imperative that we support those individuals and their systems.

 

Q: In your opinion, how important is leadership during this complex and rapidly evolving situation that we are in currently?

A: Leadership is so important under “normal” circumstances. Under the current situation it becomes critical and central.

It’s important to remember too, that we need to include both formal and informal leaders in our thinking. In these tumultuous times, many frontline individuals will be called upon to take on acting leadership roles in addition to their peer leadership roles.

 

Q: I have often heard you say that “leaders are people too.” Would you mind expanding a bit for our readers what you mean by that?

A: Leaders are often perceived as being exempt from complex stress and their consequences at the personal and professional levels. However, we often find that leaders are some of the most stressed people in organizations.

The pressures on leaders can be so intense at the best of times with everything coming down on them from on top in addition to the responsibilities coming up from those they supervise. In the current situation, these pressures will only amplify, and leaders are even more at risk for developing stress and trauma-related effects.

 

Q: I would like to talk a bit about the basics of staying well as a helping professional during these high stress times. You wrote a wonderful book called Resilience, Balance and Meaning – can you tell our readers about the focus of the book and why that might be more important than ever right now?

A: The workbook is designed as a practical, comprehensive resource to support all those in trauma-exposed work. Based on current research and best practices, it provides an understanding and action plan throughout the three sections:

The first section provides an introduction and orientation to the issues of workplace stress in trauma-exposed environments – what it is, how it works, what helps and what effects it has. The second section provides self-assessment tools that help to determine your current risk and resiliency profile, self-care status, and stress symptom profile. And the final section provides support to build a personal wellness plans for both your personal life and your work life.

Under “normal” conditions we often believe we can limp along without taking ourselves seriously – and that can seem to work for a while. However, with the current surge in stressors, we really must take informed and effective action to care for ourselves and our colleagues.

Free Resource: Self-Care Questionnaires from the Resilience, Balance & Meaning workbook

 

Q: What are your top recommendations for leaders in health care and first responders at this time? 

A: Here are my recommendations:

  • Set your realistic priorities on a daily basis and recognize what you have achieved each day.
  • Take the time to ground yourself as you finish one task and before you take on the next task (e.g. take a deep breath, Feet on Floor)
  • Stay connected with your colleagues in a kind and caring way and appreciate each other and your successes together.
  • Remember to take care of your body: hydrate frequently, make sure you have quick healthy meals and snacks, sleep as much as you can.
  • Unplug from a steady diet of news, rumours and externally imposed anxieties. Focus on what you have some control over. “

 

Q: In your book Building Resilient Teams, you talk about Stephen Covey’s circles of control and influence. I was thinking that this is a very relevant concept right now. What are your thoughts about how Covey’s circles may be a useful tool right now?

A: For readers who may not be familiar with this model, Covey identifies three zones of control:

The smallest part includes things over which we have complete control; the next zone are things we have influence over; and the last and largest zone are things that we have no control or influence.

As you think about looking after your own wellness, it is important to be clear about what you do and do not have control over. When we are faced with situations in the workplace (or in life) that are unpleasant and/or stressful we have four choices:

  • We can accept it
  • We can change it
  • We can change the way we deal with it
  • We can escape from it.

When we are dealing with circumstances outside of our control, such as the current pandemic, we need to focus on the healthiest and most adaptive approaches – either with acceptance and self-care, by changing the way we deal with it, or escape from it. 

It is extremely stressful to feel as though you have no control over the events and circumstances in your life, and your experience of them – and this is why it is so important to understand where you sit in the zone of control for the different issues you are facing right now. We need to recognize that we always have a place to find a sense of control – either over the situation or over how we choose to deal with it.”

 

Q: Finally, what is one message you would like to share with our readers, whether they are frontline workers, managers or senior leaders as we navigate through this unprecedented situation?

A: I believe we all need to keep coming back to principles of kindness – to ourselves, our families, our colleagues and our clients. 

This pandemic calls on us to change the traditional helper belief paradigm from: “Either I take care of you OR I take care of me” – to – “I MUST take care of me so that I can take care of you.”

This pandemic calls on us to change the traditional helper belief paradigm from - either I take care of you OR I take care of me - to - I MUST take care of me so that I can take care of you. Click To Tweet

 


Key Takeaways:

  • We need to support trauma-exposed workers and their organizations as they provide vital services.

  • Leadership during times of crisis is critical and central.

  • Include both formal and informal leaders: frontline individuals will be called upon to take on acting leadership roles.

  • Leaders are often some of the most stressed people in organizations.

  • During this pandemic, pressures will amplify and leaders are even more at risk for developing stress and trauma-related effects
  • Focus on the healthiest and most adaptive approaches when dealing with circumstances outside of your control. 

  • Keep coming back to principles of kindness – to ourselves, our families, our colleagues and our clients.

Concrete steps to take right now:

  1. Set realistic priorities on a daily basis and recognize what you have achieved each day

  2. Take time to ground yourself as you finish one task and before you take on the next task (eg. deep breath, “Feet on Floor”)

  3. Stay connected with your colleagues in a kind and caring way and appreciate each other and your successes together

  4. Take care of your body: hydrate frequently, make sure you have quick healthy meals and snacks, sleep as much as you can.

  5. Focus on what you have control over: unplug from a steady diet of news, rumours and externally imposed anxieties.


Resources

Resilience, Balance & Meaning Workbook by Dr. Patricia Fisher, 2016

Building Resilient Teams: Facilitating Workplace Wellness & Organizational Health in Trauma-Exposed Environments by Dr. Patricia Fisher, 2015

The 7 Habits of Highly Effective People by Stephen R. Covey, 2004

Staying Grounded in Stressful Work online course with Diana Tikasz

Resilience in Trauma-Exposed Work online course with Dr. Patricia Fisher

Organizational Health in Trauma-Exposed Environments online course with Dr. Patricia Fisher

Today, spare a thought for the call centre operators

I was catching up on the news this morning and reading about the long wait times to reach Service Canada to ask about employment insurance; about the days spent on hold by stranded travelers trying to reach airline customer service before the borders close; and other similar situations where callers are experiencing long wait times and high levels of distress and frustration.

We are also hearing about 911 communicators who are receiving large volumes of calls from both the worried-well and the mildly ill while still dealing with life and death matters. (By the way, this isn’t new for emergency communicators – as they will tell you – but the workload is unprecedented right now).

Since my team has had the immense privilege of working with many customer service workers and call centre operators in the past, from every possible industry that you can imagine,  I would like to break down what may be happening at the receiving end of that phone call, live chat or email.

Most operators were already experiencing very high-pressure work environments before this pandemic unfolded.

Large volume of calls, angry and distressed clients, not enough time for proper breaks, and even physical injuries from poorly designed workstations are just some of the stressors that call centre workers deal with on a daily basis. Many are also struggling with low pay, long hours, low reward jobs and a wide range of workplace climates from the very healthy to the, quite frankly, straight-up toxic.

I used to provide employee assistance to a call centre that had a three-month turnover rate – that’s how long their staff lasted before they quit. That being said, I have mostly worked with incredibly supportive customer service leadership – however, they are still grappling with the complex challenges of the workload and difficult callers.

The types of calls that they receive are highly varied – even during normal circumstances.

These calls can range from callers who are seriously mentally ill, suicidal, uttering threats, being verbally abusive, or even just someone who is calling the wrong service and is very upset that the operator is unable to help them.

They rarely have the power to fix your problem beyond what they have the scope to do.

Call centre operators are working within the same mess that we are all in right now including slow websites, lack of information from high above, and rapidly changing policies, rules, regulations and procedures. Yelling at them will not make them more powerful than they are – and will likely just make everyone more stressed out and upset.

In some instances, you can ask to escalate the call to a supervisor for more answers, but that can be done politely.  

Sometimes they do have some discretion to do a few extra things.

Yesterday, as I was busy working with some of my health care agencies on Zoom, my internet provider called to say that they had to interrupt my service for some not-very-urgent reason.

When I nicely told the operator about the work that I do, he genuinely thanked me for my service, and said that he would postpone the service interruption. In my experience, being kind to customer service workers goes a long way. 

Most of them are not trained in mental health first aid.

Unless they work in a highly specialized service that provides mental health assistance, most operators do not have this kind of training. Yet, many call centre operators must manage callers who are emotionally dysregulated, and this can take a real toll on them.

They almost never get closure.

Many call center operators and communicators have told me that a challenging aspect of their job is that they rarely get closure on how the story ends. This may not be particularly distressing for someone who is trying to help you activate your cell phone but can be a very real source of emotional stress for those who receive calls about stressful or traumatic situations. Some of them have told us that these calls can “hitch a ride with them” and there is rarely time for proper debriefing afterwards.

They are going through this pandemic too.

Operators have financial concerns, families, and toilet paper shortages just like the rest of us (sorry I couldn’t help myself!). But truly, these folks are rarely highly paid, and this work is how they feed their families. Perhaps their spouse is out of work right now or maybe they are trying to take these calls from a crowded, quarantined house full of kids. We just never know what’s going on in the lives of others.

My aim today is to invite all of us to show some kindness and consideration for those communicators and call centre operators, even if they can’t help us to our satisfaction. They are dealing with an unprecedented volume of requests and are working as fast and as hard as they can.

So, please spare a thought for the folks at the other end of that phone line, customer service email or live chat and when you finally get a real human being at the other end, please thank them for their service.

Dealing with Stress & Uncertainty

We all have different ways of dealing with stress and uncertainty.

Even at the best of times, I am not particularly good at going with the flow to see where things land. I like to map out the flow, control its direction and, if possible, alter where it’s going to end up.

Since this has been a core element of my personality as far back as I can remember, I have developed three essentials tools that help me stay grounded, healthy and thinking clearly even when I don’t have much control at all.

First, I go back to the books.

As an avid reader, I always start by returning to the science to find guidance from past events.

There were some very important lessons learned from the way the SARS outbreak was managed in 2003 in Toronto hospitals – both in terms of infection control and in ways that we could have provided better psychological support to our exhausted health care staff.

In an article published in 2003, Mount Sinai’s Dr. Robert Maunder outlined those recommendations and placed a huge emphasis on the importance of social support; allowing time for workers to reflect and reset between patients; acknowledgement from leadership that there has been a change in workload; and staff feeling supported by their managers.

Second, humans need social support.

Connecting with loved ones, friends and colleagues over Skype or by phone can help us ground ourselves. I just went for a long walk and chatted with my 78-year old father for an hour while getting some exercise and fresh air. I also reached out to two members of our team for a catch-up today.

Try taking a break from the news cycle and connect with real humans that you love and care about.

“…When facing such a crisis it is crucial to feel that one is not alone. All efforts to overcome interpersonal isolation, from sharing jokes on the nursing station to conference calls, serve an important role in times of intense strain and stress.”

– Dr. Robert Maunder, 2003

Third, rest, exercise and resetting.

TEND team member Diana Tikasz, MSW, RSW, is a specialist in grounding skills and the neurobiology of stress. She reminded me of the “Power of Pause” during our chat today and the importance for all of us to take short breaks in the rush of our days to reconnect with our breath and remain present to ourselves.

“If all else is going wrong around us, we always have the ability to pause and choose where to focus. Don’t believe everything you think—we cannot control the thoughts that pop in our head, but we can be aware of them. With awareness comes choice.”

– Diana Tikasz, 2018

In his post-SARS article, Dr. Maunder wrote that we are “normal people dealing with extraordinary events” which I loved. He reminds us that the people that we serve will continue to need us, as will our loved ones, but that we are not alone.

Let’s support each other with compassion, kindness and presence. Let’s connect to share tools that work for us during uncertain times.

Resources:

Maunder, R., Hunter, J., Vincent, L., Bennett, J., Peladeau, N., et al. (2003). The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ, 168(10), 1245-1251.

Feet on the Floor – Grounding Technique with Diana Tikasz

Looking for support? Join our Facebook group. 

 

Conversations on Compassion Fatigue with a Minister & Police Chaplain

 

Conversations on Compassion Fatigue is a series where we interview professionals from high-stress and trauma-exposed environments to discuss issues around compassion fatigue, organizational health, vicarious trauma, moral distress and self-care.

We sat down with a Minister and volunteer Police Chaplain to discuss his personal experience with compassion fatigue, how it helped him connect with police and first responders, and his strategies to manage stress and burnout. 


Can you tell us a bit about your work as a Minister & Police Chaplain? 

“I’ve been a minister since 1998. I am currently based in Western Ontario serving in a Presbyterian church but have served in several different churches throughout Ontario. I also serve as a volunteer chaplain for our local police service.

In addition to my ministry work, I teach courses on maintaining healthy boundaries, managing multi-staff teams, formal mediation skills and coaching skills at a local college. I am passionate about engaging with my community and have been involved with organizations that support poverty elimination and affordable housing.

What has been your experience with compassion fatigue?

There was a time earlier in my career when I truly thought: “I can’t do this anymore.”

One thing that was really getting to me was the amount of people telling me that they had been diagnosed with an illness. In speaking to a counsellor at the time, I remember telling them that I just couldn’t handle one more person with bad news from the doctor’s office.

I was also starting to get déjà vu moments when visiting someone in hospice or the hospital. I would be in a room visiting – and have the eerie realization that I had been in this exact same room just last week visiting a different person.

I remember thinking: “I don’t want to be compassionate anymore. I’m fatigued. I think I got that thing.” I am a voracious learner, so I had heard the term compassion fatigue before and kind of understood what was happening. 

What did you learn from your experience with compassion fatigue?

One thing that has been particularly helpful in working as a volunteer police chaplain is learning that there are many parallels between the work of ministers and of first responders. 

Not everyone is a Christian – so, when you’re a person of faith working in public service, you need to approach it in a way that resonates with others and in a way that is useful to them. I’m not there to proselytize and I don’t show up with a ‘Team Jesus’ t-shirt. It’s all about building rapport. 

One parallel between my work and that of first responders is this funny shift in perception that can happen when someone finds out what you do for a living. People start to act a little weird and change how they behave – they might censor their language or immediately start telling you all of their problems.

There is also a professionalism piece that is similar. Whether it’s to speak to a witness or to offer words or a prayer, you’re in a situation where people are mourning and people are hurt. But you have to maintain your professionalism and do your job – that can be difficult.

For those who work with trauma, we might be impacted by trauma every week – sometimes every day.  We need to learn to be aware of our own baggage. If we’re carrying a lot of shame or anger, those things can start to impact us and our ability to do our jobs.

It can be difficult to talk about these things with first responders. One tool that has been helpful when I talk to them is the idea of ‘seepage’. I might say to an officer who is struggling: “I think your bucket is full – and its seeping out in weird ways.”

That kind of language seems to resonate with them and has been useful to open the way for conversations on compassion fatigue and other difficult things.

In your field, what do you think could be done to mitigate the effects of compassion fatigue?

Self-care isn’t really part of our training in the ministry. As a population, we don’t look after ourselves very well.

I think one of the biggest challenges in the world of ministry is around boundaries. As ministers or chaplains, we often get embedded into people’s lives – and that can easily spill over and blur the lines. Social media is a great example. 

I’m not on social media and I don’t do pastoral care on Facebook, but some of my colleagues do. With social media, you’re always working and you’re always on, and its easy to inadvertently disappoint people. If someone posts something about a difficult situation and you don’t comment or don’t see it, that person can be disappointed or even angry. And that’s a lot of extra stress and pressure.

Another challenge that I see in my work is related to this idea that, if you are suffering, you must be doing your job well.  Some ministers or chaplains don’t appreciate their limits and and are constantly burning the candle from both ends.

We all know that trite saying about oxygen masks – but its true. In order to do this work well, we must recognize our limits and learn how to take care of ourselves. 

What does your self-care practice look like?

I am very intentional about my time off – when I’m off, I’m off. Being firm with your boundaries isn’t something that makes you very popular, but it is important for myself and for the people I serve. 

Each year I take a silent retreat in a monastery in the States. During this time, I don’t talk to anyone or use any technology. The first year, it was difficult to disconnect from work since people have expectations about what you should or should not be doing.

But if you’re firm, people will eventually acknowledge the boundaries that you set.

One year when I was away, our church steeple got struck by lightning – and no one from the church contacted me about it. I found out about it in a funny way. I was talking to someone in the police service and as they were hanging up, they said: “Oh, and sorry about your steeple getting scorched.”

I didn’t rush back to help with the situation. One of my mantras is: “I serve a role and I’m important – but I’m not irreplaceable.”  I knew that there were capable people who were handling it and I would do my part when I returned to work. You need to have faith that others can figure things out in your absence. 

One of my mantras is: “I serve a role and I'm important – but I'm not irreplaceable.”  You need to have faith that others can figure things out in your absence.  Click To Tweet

What do you find challenging about your work?

One of the biggest challenges of working in ministry is when our values as an organization don’t match up with our actions. As a church community, we express things like “loving our neighbours” – but then, we don’t act very lovingly to our neighbours.

This has big implications, but I’ll give you a small example. A few years ago, our congregation wanted to purchase fair trade coffee for our events to support ethically sourced products. However, it turns out that fair trade coffee is a heck of a lot more expensive than a can of Folgers. Plus, we were still using disposable Styrofoam cups and offering bottled water because it was convenient and cheap. 

We preach concepts like caring for the environment and supporting others – but then sometimes decisions are made that are based on self-interest. It can be heartbreaking and difficult, especially when you are in a leadership position. 

What do you find rewarding about your work?

I love having the opportunity to talk to people about stuff that is meaningful to them. I really enjoy talking with people and having in-depth discussions about this crazy life of ours. It really jazzes me up. 

I have the privilege of being with people and supporting them during the most challenging situations that we encounter as human beings. It’s incredibly challenging but I think it’s part of how I’m wired – I love what I do and it’s an incredible gift.

Do you have any favourite resources or books that have helped you in you work?  

The Body Keeps the Score by Bessel van der Kolk and anything by Brené Brown.” 

Coming Home to Secondary Traumatic Stress

Someone looking into car rear view mirror with sunset in background

I recently had a challenging week managing my secondary traumatic stress reactions.

What happened felt long past and yet familiar – I had not experienced symptoms this strong since leaving full-time clinical work. It kind of caught me by surprise, although, in hindsight, it shouldn’t have, and I think I know why it happened:

I had been working long hours in the office and sleeping less than I needed  – because summer is short in Canada, and the sun was shining, and the nights were balmy, and there was live street music to be enjoyed, and late-night conversations with dear friends to be had, and BBQs to be cooked and shared with my wonderful children and their friends.

I had also been reading a beautiful, but deeply disturbing, fiction book before bed (I know, I know) and had spent six hours on a drive listening to a podcast about a con artist who ruins people’s lives. (I KNOW – “What the heck?!” right?)

Basically, I was doing all the things that I tell other people not to do – lack of sleep, extraneous trauma exposure, poor pacing…and my fatigue and vulnerability sort of crept up on me.

Then, in rapid succession during that same week, I heard a series of terrible trauma stories at work. If you work in this field, you know the ones that I mean: those that bring up another case that you thought you had long forgotten and had stored far in the recesses of your brain; or an image that sends a chill right up your spine; or stories that make you stop breathing for just a second as you lean towards the pain and suffering of the person in front of you, in a state of deep empathy.

To top it all – and this is important – one of these stories wasn’t something that I heard at work: I was visiting with a friend, having a lovely catch-up, sitting in the garden, and forty minutes into our chat, she shared, without warning, a terrible story that had just happened to someone in her life on this very same day. She shared all of the sounds and images of the accident as people do when they are processing trauma. I don’t blame her for doing that, she was traumatized and needed my support and that is absolutely fine, but because we were chatting casually and I didn’t know the story was coming, it caught me off guard and hitched a ride with me for a few hours. 

 

Coming Home

 

When there is a lot of secondary traumatic stress (STS) in me, I tend to withdraw from my family or steer all conversations towards hard topics related to my work. I still “show up” and cook and clean and do groceries and hug my kids, but I have very little mental energy left to engage in non-trauma conversation – especially if the topics are “civilian” concerns (the latest Congressional hearing? Blah) or one of my family’s three favourite topics (politics, gender politics, college basketball – someone save me). I normally enjoy a good smart debate about all of these topics, but when I’m full of STS, I just wish everyone would talk about cute puppies OR trauma.

This, in and of itself, is a solid warning sign for me, and I noted it as it occurred.

At the end of that week, my partner and I went on a lovely drive to visit some friends who live upstate New York – lush rolling hills and great music playing in the car.

I was quiet and reflective for the first hour. Finally, I told him – “This was a hard week for me. I heard a lot of difficult things, and although I won’t slime you with the content, it made me reflect on how it used to be for you when I did front-line trauma work full-time.”

He looked far off into the distance, took a deep breath, and replied: “Those times were really hard.” 

Ok, so he’s a man of few words, but I knew what he was saying because we have been together for 30 years, and he has been a witness to my entire journey as a trauma clinician. We have discussed, in the past, my sometimes difficult transitions back into our home life, my irritability and lack of engagement in things that he is passionate or interested in. The way I sometimes withdraw to bed at 8pm because I am completely maxed out.

What is it like to be in a relationship with us? What is it like to be our friend when we don’t return calls for weeks or show up at birthday parties and tell a trauma story we think is hilarious but no one else does?

 

Resetting our Foundation

 

So yes, I hear a lot of hard things in my job – and I am sure you do too – and it’s normally fine because I have a whole arsenal of tools to pace and reset myself, but that week, because of my “summer 2019 extravaganza” behaviours, I wasn’t as prepared and grounded as I usually am. I was working with a shakier foundation.

Since I teach and write about secondary trauma for a living, I also watch myself very carefully and take mental notes:

  • “Feeling very anxious for no reason”

  • “Decreased appetite”

  • “Hmm, interesting choice of night-time reading…”

  • “Check me out picking a fight with my son before I even put my briefcase down –  even though I had told myself ALL THE WAY HOME not to talk about this immediately as I walked in the door.” (Awesome parent of the year award…)

By Friday midday, I was feeling completely out of sorts. However, because I know my STS symptoms so well, I didn’t let these things go on for very long.

I decided to call it a day and took myself offline for a bit. I went to do some non-trauma related stuff for myself (insert your favourite self-care activity here) which, on that day, involved a pedicure and buying a tool at the plumbing supply store.

(And, yes, both things can co-exist in a person – a pedi and some bad-ass DIY.)

Yet during this mini-break, I noted my persistent level of hyperarousal. Throughout the afternoon, I was unable to shut off the overactive thinking and the list making. 

So, I took a deep breath, went home, put the terribly sad fiction book away, watched an episode of Queer Eye (I LOVE THEM) and went to bed early for a proper night’s sleep.

Coming home to STS is an ongoing process – we need to remain self-aware, take notes of shifts in our behaviours, pace ourselves and listen to our loved one’s feedback when they say “you are not yourself today” (without biting their heads off). We also need to rest and restore our bodies and our brains, so that we can continue being present to all aspects of our lives. 

Coming home to secondary traumatic stress is an ongoing process. We need to remain self-aware, take notes of shifts in our behaviours, pace ourselves, and listen to our loved one’s feedback. Click To Tweet

This leads me to asking you the following questions:

  1. If you are a trauma-exposed professional, have you asked your loved ones/friends what it’s like to live/hang out with you when you are in the Yellow zone?

  2. What would they say about how you transition from work to home?

  3. What would they say about the impact hard stories and cases have on you? On them?

  4. Have you developed a keen self-awareness about your warning signs and when it’s time to take stock and reset yourself?

As I finish writing this post, I am sitting in my garden on a cool Sunday morning. There is a light breeze blowing and my daisies are gently bending in the wind. The raccoons that live under my shed just came home from their night of carousing and gave me a nod as they crawled back in their den (we have an understanding – they don’t bother me, I don’t bother them).

I feel strong and rested, but I am also keeping a close watch on my thoughts, behaviours and choices that I make about taking care of myself. I love trauma work, but it can’t dominate every aspect of our lives if we are to continue providing high quality, ethical care.

There are so many things that we have no control over in our work – but how we take care of our bodies and our brains must remain at the top of the list.


Recommended Resources:

[Online course] Window of Tolerance Framework (WTF) – Strategies to keep helping professionals grounded and centered

[Online Course] – Compassion Fatigue 101 

Mental Health and the Classroom – with Dr. Mike Condra

 

“Mental Health and the Classroom” with Dr. Mike Condra

 

 

Presented as part of a panel discussion on mental health in Kingston, ON, April 11, 2015. 


TEND Associate Dr. Mike Condra is an Adjunct Assistant Professor in the Department of Psychology at Queen’s University and has taught in the undergraduate and graduate programs in the Department of Psychology and in the faculties of Education and Law. 

If you’re interested in having Dr. Condra speak at your organization, contact us at info@tendacademy.ca.

Learn more about Dr. Condra’s live training.

Mental Health: Awareness, Anti-stigma and Helping Skills

Compassion Fatigue and Secondary Trauma – Essentials

Contact us for a customized training for your workshop.

Hot Walk and Talk Protocol

Protocol for the Hot Walk and Talk

©2012 Patricia Fisher, Ph.D.

This protocol applies when there has been no physical injury and the person is stable enough in the aftermath to proceed. In the event that the individual has been physically injured or is in shock you would need to follow emergency procedures and get the appropriate immediate medical resources.

This protocol is designed to provide helpful first aid immediately after a team member experiences a particularly distressing or disturbing incident and is undergoing a completely normal stress reaction. This is something either supervisors or peers can offer each other and you will consider what would work best for you in your particular circumstances.

Remember that when we are experiencing a high stress response our body is in the flight, fight or freeze state and we are flooding with stress hormones and all the physical, emotional and cognitive responses that go with that. So, our first response introduces safety and containment for the person.

The following steps in the process are typically helpful:

  1. Go to the individual, ensure that they are physically out of danger, and ask them to come walk with you.
  2. Walk away from the area where the incident occurred and toward a neutral or safe area (if you can get outside that can be even more grounding).
  3. Walk beside them and set a pace that is brisk enough to engage the individual and help them discharge some of the distress… as the walk proceeds you may find that they naturally slow the pace – let them progressively have more control over the pace as the debriefing proceeds.
  4. Bring a bottle of water and have them drink the water as you walk
  5. Let them know that they are safe now and you are here to support them as they move through this absolutely normal response to high stress.
  6. Ask them to tell you what happened in their own words, if they seem stuck in the incident, prompt them to move on with the narrative by asking “and then what happened”. You want to help them move through the whole narrative from beginning to the end – until they get to the present where they are walking with you in safety and are no longer at risk.
  7. After you have gone through this initial debrief you may work in an environment where you are required to complete an incident report. If this is the case, go with the individual and ask them how you can help in completing the report. They may want you to type in the information as they dictate it, or they may simply appreciate your presence while they complete the report.
  8. Remember to remind them to focus on their breathing and open posture to help them deescalate from the stress response – especially after you have stopped walking and may be standing or sitting.
  9. After the initial debrief and report (if required), ask the person what they would find helpful now? Do they want to phone a family member, get a sandwich, take a break, go back to work? They need to have control over their choices while attending to their needs.
  10. Let the individual know that you will remain available to them and encourage them to access addition supports that may be available if they would find them helpful (e.g., Employee Assistance Programs, counselling, other community resources)

Following, and sometimes parallel to, this immediate first aid response, there may be additional steps needed from an institutional perspective. These may include:

  • 􏰃  The debriefer stays with the affected person, and asks a colleague to notify the supervisor about the incident. The debriefer can provide updates to the supervisor as needed.
  • 􏰃  The supervisor speaks with the affected person(s) and assesses whether the person should remain at work following the incident. The debriefer or supervisor assists with making travel arrangements if the affected person is not in a condition to drive home. If the affected person goes home early, the supervisor phones the affected person to ensure that they arrived home safely.
  • 􏰃  The debriefer emails a summary of the incident to the supervisor, based on the information gathered from the affected person. The supervisor may also be responsible for submitting paperwork.
  • 􏰃  The supervisor updates other staff in the office about the incident, as needed.
  • 􏰃  The supervisor works with the affected person(s) to discuss any case management or other relevant

    decisions in relation to the incident.

  • 􏰃  The supervisor will check-in periodically with the affected person and continue to offer support in the weeks that follow.