Bridges out of Poverty – resource recommendation

Bridges over Poverty, blog post, resources for compassion fatigue and trauma exposure

review by Françoise Mathieu, M.Ed., CCC., RP

Bridges out of Poverty: Strategies for Professionals and Communities – a great resource to develop more compassionate and effective tools to support individuals who live in underprivileged communities.


If you work with folks who live in poverty, these challenges are often multigenerational, complex and very difficult to overcome. Whether your clients are inner-city dwellers with its host of challenges or are individuals trying to make ends meet in remote communities with a lack of basic public amenities and transportation services, this book is a fantastic resource.

Bridges out of Poverty, written by Dr. Ruby Payne, is both a book and an entire community-building program to enhance service providers’ understanding of the complicated layers and resiliency of those who live in chronic poverty.

I was introduced to the book several years ago by a lovely workshop participant from Nebraska who has been involved in bringing the program to his community. I read it from cover to cover as soon as I received it.

Ruby Payne does not only provide a template to assist people living in poverty gain better access to the supports they need, she also invites the reader to reflect on the admirable strengths, resourcefulness and resiliency of folks who have had to struggle to have even the most basic resources: shelter, food, jobs, transportation and much needed health care.

Those of you who have heard me speak in the past know that I am a firm believer that the key to compassion satisfaction and improved quality of care for everyone begins with developing a better understanding of the strengths and challenges of those we serve. This book is a great place to start.


Sources: 

Payne, R. K., DeVol, P. E., Smith, T. D., (2001) Bridges out of Poverty: Strategies for Professionals and Communities. Houston: AHA! Process.

What is Organizational Health?

Organizational Health

Downloadable PDF to share with your organization

It is widely accepted that many jobs are stressful. Anyone working in fast-paced, high-pressure environments can attest to the wear and tear that they can experience over time when the demand outweighs their capacity to deliver, or when the work is dangerous or numbingly repetitive, when the hours are long, and the pay is low, or when they work in a service industry where dissatisfied customers use staff as a lightning rod for their frustration or even, at times, their rage.

Ask any airline customer service agent what it is like to handle a horde of angry travellers when all flights have been delayed by an unexpected storm and this poor person’s power to solve the dilemma is limited, or even non-existent. Ask the factory worker operating a dangerous machine for 12 hours a day on a line with poor working conditions and a hostile climate. Ask the call centre operator (call centres have one of the highest turnover rate of any job at the current time) where you are underpaid, monitored for the length of your calls (“that was too long” “you said the wrong thing, take the next call, go go go!”), and sometimes they don’t even have the right to go to the bathroom during a shift without being penalized. The speech writers working to deadline, the day trader, the server in a diner who is on their feet for 12-hour shifts, air traffic controllers … the list is long, and most of us have worked in such settings at some point in our lives.

The term organizational health refers to the varied and often complicated factors that affect the capacity and performance of an organization. Work hours, type of work, stress levels, budgets, workload, turnover and so many other factors all have an impact on the health of an organization.  At the very core of this is the health of each individual including: how they feel about their jobs, how they perform them, how committed they are to their roles and how their jobs are affecting them personally.

How Does Workplace Trauma Exposure Affect Organizational Health?

Stress has an enormous impact on the health of an organization, and when the added element of secondary and/or direct trauma exposure is present, balancing workplace wellness becomes far more complicated, and we would argue, even more critical. High-stress, trauma-exposed work environments such as health care, law enforcement, mental health services, child welfare and many other related fields have unique and specialized organizational health needs.

 

Why Don’t Employee Wellness Initiatives Always Work?

Many human resource companies have become interested in staff wellness over the past two decades and have explored ways to reduce burnout, increase employee satisfaction and eliminate workplace grievances, disability claims and attrition. Some of those initiatives have been effective, but the generic “in-the-box” workplace wellness programs have not always been successful in the complex settings that we, at TEND, work in: hospitals, correctional facilities, child welfare, law enforcement, anti-human trafficking, refugee boards and similar challenging work environments. Over the years, we have been approached by leadership in these workplaces who are extremely concerned about the emotional and physical health of their staff and are witnessing high turnover rates, low morale, and difficulty attracting and retaining skilled labour.

 

A Framework to Understand Organizational Health in Trauma-Exposed Settings

 TEND’s Co-Executive Director, clinical psychologist and trauma specialist Dr. Patricia Fisher, became very interested in the truly unique characteristics of workplaces that have regular exposure to a combination of high stress, high volume of work, diminished resources and trauma. Dr. Fisher has spent the past two decades developing a framework to understand these workplaces which she refers to as “high-stress, trauma-exposed” work settings.

Dr. Fisher developed the Organizational Health Model for Complex Stress environments that can assist leadership in developing a better understanding of best practices and effective interventions to support their teams.

Dr. Fisher’s model has demonstrated that we need to start with the foundation elements which are Leadership, Succession Planning and Health and Wellness.

Leadership: Leaders are people too, and they are powerful role models for their staff. Leaders are also often working under extremely high stress burdens themselves. We also need to remember that leaders are often promoted into their roles with very little training or experience managing other people, and we need to give them the time, support and training to get competent in their new role.

Succession planning refers to several factors: addressing the inevitable loss of staff through retirement (a very large demographic shift that we are in the midst of, with many Baby Boomers retiring), illness and job change, and the critical need to attract and retain new hires such as Millennials who often have different priorities and values in terms of work-life balance. As the proportion of new workers in teams increases, we often find that the more experienced staff are depleted and have sometimes become disillusioned and are, as a result, unable to perform the crucial role of supporting and guiding their more junior team members.

Health and wellness is also an essential element. New research on the impact of toxic stress has clarified how trauma-exposed work creates a unique climate with increased risk for serious stress and burnout effects for individuals, leaders and teams. These can inevitably lead to a rise in sick time, low morale, lack of team cohesion and high turnover. These consequences can, in turn, seriously limit a team’s ability to work effectively and efficiently.

 

Where to Start?

The good news is that there are some excellent resources to help high-stress, trauma-exposed organizations assess their functional capacity and decide where to begin in implementing effective strategies to support their teams.

 

1) The Secondary Traumatic Stress Informed Organization Assessment Tool (STSI-OA)

Dr. Ginny Sprang, from the University of Kentucky and some of her colleagues (Sprang et al, 2014) developed a free Organizational assessment tool: the Secondary Traumatic Stress Informed Organization Assessment Tool (STSI-OA). The STSI-OA is an assessment instrument that can be used by any organizational member at any level to evaluate the degree to which their organization is STS-informed, and able to respond to the impact of secondary traumatic stress in the workplace.

To access this test, go here: http://www.uky.edu/CTAC/STSI-OA

Click Here to read an article on the psychometric properties of the STSI-OA

 

2) Organizational Health in Trauma-Exposed Environments – Online Course

This intensive online course was designed by Dr. Patricia Fisher for managers and supervisors of teams working in high stress, trauma-exposed environments. The course supports participants to be effective leaders and to build strong, resilient and productive teams by exploring their vital role in Organizational Health and recognizing the impact of chronic stress on individuals, teams and organizations.

LINK to the COURSE Here

 

3) The Organizational Health Roadmap

Dr. Fisher also developed the Organizational Health Roadmap to meet the needs of the thousands of individuals from so many trauma-exposed fields who have taken our Organizational Health and Leadership training and who asked for more resources to take them beyond the basics. The Organizational Health Roadmap provides a guided 10-module program that supports your Implementation Team as you develop a practical and sustainable action plan to meet the specific need and circumstances of your team.

While trauma-exposed organizations share a range of specific risks and resiliency factors, the Roadmap program recognizes that each workplace experiences a unique profile. You are the experts in your own workplaces – and the Roadmap is designed to guide you as you first evaluate your own unique resiliency and risk profile, and then build a custom set of practical solutions and implementation plans to fit your specific circumstances.

Organizational Health, wellness

Learn more about the Roadmap here
Books by Dr. Patricia Fisher

 

Sources:

 Fisher, P. (2016) Building Resilient Teams: Facilitating Workplace Wellness & Organizational Health in Trauma-Exposed Environments. Kingston, TEND ACADEMY.

 Sprang, G., Ross, L., Blackshear, K., Miller, B. Vrabel, C., Ham, J., Henry, J. and Caringi, J. (2014).  The Secondary Traumatic Stress Informed Organization Assessment (STSI-OA) tool, University of Kentucky Center on Trauma and Children, #14-STS001, Lexington, Kentucky.

Balancing our Work and Life while Staying Well – Five Essential Tools

By Françoise Mathieu

This post was initially published on the Oregon OEA Choice Trust website: http://oeachoice.com/5-essential-tools-for-balancing-your-work-and-life-while-staying-well/

I grew up in a family of educators. My parents moved from Montreal to the high arctic in the early 1960s and worked in a variety of schools in very remote Inuit communities for the following decades. Over the years, my father was a teacher and then became school principal, then superintendent and eventually director general of an entire region. He travelled extensively for work, visiting numerous villages for a third of each year, dealing with labour disputes, financial cutbacks and the complex societal challenges facing First Nations communities. My mother co-developed one of the very first teacher training program for Inuit women in Canada.

Needless to say, my parents were very dedicated and hard-working. Education reform and the challenges of the work was daily conversation in our household. Working as educators in small communities presented many challenges and rewards: our house was often the informal hotel, food bank and shelter, and villagers would frequently knock on our door for advice or support.

Are you living in the community that you serve?

If you live and work in the same community, you may have experienced something similar: you go to the grocery store on a Saturday in your sweatpants, and a parent accosts you for advice on their child’s problematic learning difficulties. You go to a party and are immediately grilled on your thoughts about educational policies or the best ways to beat the SATS.

How do you find balance between work and your private life?

I would say, in hindsight, that my parents were frequently completely exhausted at night, and did not know a thing about work-life balance. Being from the War Generation, born in the 1940s, their cohort had not learned about the importance of balance and self-care. For them, you worked until you fell down, and then you got up again and worked some more. They had very little time for themselves. This was the norm among the educators that I knew.

Burnout Research

So how can we find balance working in the education field? How do we learn to set limits so that we can bring our best selves to work and yet not burn out? How do we juggle the competing demands of our home lives and careers?

Notions of self-care are fairly new to the education field. In fact, it wasn’t until the late 1980s that researchers started investigating the concept of work-related burnout among mental health professionals and nurses.  Compassion fatigue, the emotional and physical exhaustion that can lead to a shift in our ability to experience empathy for others is a concept that emerged in the 1990s and lead to the growth of an entirely new field exploring provider wellness.

Here’s what we now know: we cannot expect to work in highly demanding and frequently under-resourced environments without taking some active steps to maintain our emotional and physical health. Some workplaces have implemented some very successful workplace wellness initiatives and we have featured them in our article “Beyond Kale and pedicures” (https://www.tendacademy.ca/wp-content/uploads/2016/01/BEYOND-KALE-AND-PEDICURES-Article.pdf)

The good news is that we now have over 25 years of research that map out what works and steps that we can each take to stay well. I have written extensively on this topic in my book The Compassion Fatigue Workbook and related articles.

Here are my top five favourites:

What works? 5 Key steps

Step one: Take stock

Cheryl Richardson wrote an outstanding book called Take Time for your Life in 1990 which provides a great self-assessment checklist called “What’s draining you?”. Richardson invites readers to identify the main drains on their energy: relationships, environment, body mind and spirit, work and money. Completing this checklist allows you to decide where to begin. Which of these areas is causing you the most stress at the moment? Which area shows the most possibility of improvement?

Step two: Identify your warning signs

How do you know you’re headed for trouble? What are your most recurrent physical warning signs? What about emotional reactions? Have you noticed some predictable behavioural patterns that show up when you’re overloaded? Learning to recognise your top three warning signs can help you catch things early before you become too depleted.

Step three: Pick your battles at work

The field of education is complex, and frequently under-resourced. Some of us deal with these realities more successfully than others. If you work with a colleague or a team that is frequently negative or engage in constant office gossip or naysaying, consider making more strategic alliances in the workplace. Venting once in a while is fine, daily gripe sessions bring nothing constructive to the workplace.

Step four: develop a community of support

Research has shown that social support is one of the best strategies to address compassion fatigue and burnout. Who are your accountability partners? Who do you spend time with at work and at home? Can they be there to help you stay on target with your self-care goals?

Step five: Reassess where you are at regularly

I recently wrote a new year’s resolution blog post on my website: www.tendacademy.ca where I discuss my lack of enthusiasm for new year’s resolutions. Rather than making big commitments once a year, I prefer to have weekly tweaks and adjustments. On Sundays, each week, I take gentle stock: how am I doing? What needs more attention? What needs tweaking?

Conclusion

My parents excelled in their careers, but it took a significant toll on their health and their personal lives. I look back on their work with admiration but also see a cautionary tale of working without balance. We know better now. Where will you start?

Developing An Action Plan

via GIPHY

New Year – New you Part 4 – Developing an action plan

Part one: New Year – New You  link here

Part two: Taming the Inner Critic link here

Part three: link here

One of my favourite books on making lifestyle changes is Take time for your life by Cheryl Richardson. Written quite some time ago, it remains, to my mind, one of the best life coaching books out there.

Cheryl Richardson invites us to take stock of all the drains on our energy: financial, emotional, spiritual, physical, clutter, etc. and helps us map out an actionable plan.

Another good book is Finding your own north star by Martha Beck.

Both of these authors invite us to reflect on our priorities and assess whether our daily decisions reflect what matters to us most.

So, where can you begin?

Who do you need in your corner? Do you have an accountability partner?

What obstacles do you anticipate?

If your goals don’t pan out at first, what is your plan to remain compassionate towards yourself and reassess your goals and adjust them?

I have always found it easier to focus on manageable changes in my life. I may not be able to pay off my mortgage in a year, but I can certainly commit to not buying lunch three days a week and put that money aside in a savings account.

It can also be helpful to create a support system with a few friends who share your goals and you can offer each other moral support when things get challenging. I know for a fact that I only get up to go to my 6am workout five times a week because I really enjoy my gym friends and we encourage each other to show up each day. If I don’t show up, I get a text that says “come tomorrow!” and so I do.

In conclusion, I don’t believe in New Year’s resolutions, but I do think that we can all make small realistic changes that can have a powerful cumulative impact on our physical and emotional wellbeing. The key is to decide where to begin and be prepared to make many course corrections along the way.

More resources: The Compassion Fatigue Workbook, TEND Resources.

Taming the Inner Critic

 Part two – Taming the Inner Critic

To read week one go here: https://www.tendacademy.ca/newyearnewyou/

Ah, the inner critic… You know, that angry, negative voice that most of us carry within us. The one that is hurling insults and blame at us and saying things like “what’s wrong with you? You’ve been here before, how can you have allowed this to happen YET again?” a well-honed voice that knows exactly what to say to make you feel like you have failed in your new commitments to do better.

 When I feel overwhelmed and unhappy with my physical, emotional or financial health, I start by taking a deep breath.

Really, try it now. Take a nice long deep breath.

Next, I start paying attention to my inner-critic and try to have a detached compassionate look at what is going on.

I acknowledge the inner critic and I try to park it to the side: “I hear you, old friend, there you are, good old faithful negative voice, you!”

If that doesn’t work and I feel really overwhelmed by the negative voice, I call or text a friend, someone who knows me well and who will lovingly provide me with support. Someone who has been around long enough to know my patterns and can be a strong sounding board. This person doesn’t need to solve anything, they just need to be able to listen, with love.

If that doesn’t work, and I’m really feeling distressed and paralyzed, I call a trusted therapist and get some additional support.

Over time, I have found some strategies that have helped me stay on top of my stuff.  One of them is reflection and processing work. Getting a better understanding of my family history, the triggers and strengths and a sense of the lifelong patterns of my life.  If you had a difficult childhood, and this is a continuous struggle for you, I highly recommend that you read Donna Nakazawa’s book “Childhood Disrupted” which is full of tools to manage difficult emotions for those who had adverse childhood events.

The tool that I use daily is called self-compassion. Dr. Kristin Neff is the author of a book and series of resources on Self-Compassion, and I highly recommend that you check it out (http://self-compassion.org).

The key aim of self-compassion is to learn ways to soothe ourselves when we are overwhelmed and self-blaming. The fact is that sometimes we make mistakes, maybe even really screw up, and other times what is happening to us is truly outside of our control. Neff offers some powerful words of wisdom and some guided meditation tools on her website.

Helping professionals tend to be pleasers, doers and often perfectionists. It makes us great at our jobs but also puts us at risk for overcommitting ourselves, burnout, exhaustion and self-neglect. We need to find ways to manage our own energy before we can be of service to others. A good starting place is to make self-care resolutions that are realistic and achievable.

Next Week: Take stock

Week four: Develop an action plan

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

The information in this article is adapted from “The Compassion Fatigue Workbook

Click here for downloadable PDF to share with your organization

 

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 does not have the words to explain what is 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.

 

Developing a Warning System

 

Say 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.

 

Three Levels of Symptoms

 

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.

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

Physical Warning Signs

  • 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

  • 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

  • Emotional exhaustion
  • Negative self-image
  • Depression
  • Increased anxiety
  • Difficulty sleeping
  • Impaired appetite or binge eating
  • Feelings of hopelessness
  • Guilt
  • 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
  • Suicidal thoughts

Suicidal or hopeless thoughts? Get help: Remember that no matter how stressful and/or traumatic our work, 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. Don’t suffer alone. Get help. You deserve it and so do the people who love you.

Check out this additional post for more information on symptoms: Extra Information on Signs and Symptoms of Compassion Fatigue and Vicarious Trauma

 

Take Stock

 

Once you have read through and circled your most frequent warning signs, try and identify your top three most frequent 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 or the availability of debriefing and grounding strategies. You may also  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 consider consulting with a well-trained mental health professional who is familiar with vicarious trauma and the nature of the work that you do.

Continue reading: Tools to Reduce Vicarious Trauma, Secondary Trauma, and Compassion Fatigue

Need more resources? Check out our online courses.

 


Resources for Individuals

 


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

The information in this article is adapted from “The Compassion Fatigue Workbook

Click here for a downloadable PDF to share with your organization

 

“What can I do personally and professionally to reduce the negative stress-related effects of my work?”

We have many resources to recommend. At the bottom of this page, you will find an extensive list of resources, recommendations and selected articles.

[Please note that the outside resources listed here are for reference and personal interest only. It is not intended as a recommendation or endorsement of organizations.]

 

Where to start?

 

For starters, it is helpful to identify 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?

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

 

Which of these factors are true for you?

 

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 your work:

 

Personal Vulnerability

Do you have your own history of trauma? Are you currently struggling with a difficult family/personal circumstance? Do you work with a population
that shares some of your own personal experiences of oppression and/or discrimination? 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 this Venn Diagram are most salient for you, and begin by addressing those that feel the 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.


TEND Training

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

Online Courses: Cutting edge online training for high-stress and trauma-exposed workplaces. Discounts available for larger groups. 

Attend a TEND Conference

TEND Books

Building Resilient Teams by Dr. Patricia Fisher – 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 by Dr. Patricia Fisher – 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 by Françoise Mathieu – a lifeline for any helping professional facing the physical and emotional exhaustion that can shadow work in the helping professions

TEND Resources

TEND Blog – frequent posts on topics related to stress, wellness, compassion fatigue and trauma from Françoise Mathieu, Dr. Patricia Fisher and TEND associates. 

TEND Newsletter Archives – archived records of past TEND newsletters, a curated collection of resources related to wellness, burnout and stress.

Compassion Fatigue + Resiliency in Professionals – a Facebook group moderated by TEND that encourages discussions related to compassion fatigue and building resiliency in professionals from a vast array of professions and backgrounds

 


Other Suggested Resources

Secondary Traumatic Stress Consortium [Website]

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 Its 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.