The Human Face Of Compassion Fatigue In Schools

The Human Face of Compassion Fatigue in Schools Kathleen Beauchesne, PhD, MBA, MSW, LCSW-C [email protected] April 27, 2006

Goals for Today  

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Discuss the signs and symptoms of compassion fatigue vs. burnout Understand the role and responsibility of the work environment in situations of burnout and compassion fatigue Understand and prepare for personal reactions you may experience in situations with students and their families Strategies teachers and staff can develop to care for one another Specific coping strategies will be discussed

Elements of this Workshop 

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Part One: Assess yourself. Complete the Compassion Satisfaction and Fatigue Subscales of the Professional Quality of Life Scale Part Two: Assess your situation at work Part Three: Development of skills and behavioral plans to interrupt burnout Part Four: Wrap up

What would you like to learn in this workshop?

Social Workers: At Risk    

Intensely involved with people Highly motivated and idealistic Meaningful work/most stress prone Tougher business Longer hours  Poor pay  Lack of control over clients  Few second chances  Agency red tape  Poorly functioning clients 

Part One: Self Assessment 

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Please complete and score the Compassion Satisfaction and Fatigue Scales Score your results You will have 3 scores: 1. ________Compassion satisfaction  2. ________Burnout  3. ________Compassion fatigue/ secondary trauma 

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In pairs or threes, discuss the following questions---

Signs and Symptoms: The Cost of Caring (MacEwan, 2005) What are your experiences listening to stories of trauma?  What are the effects on you of listening to these stories?  How do you cope with listening to stories of trauma? _________________________________  What are the benefits of doing this work?  What strategies do you recommend to maintain your health and well-being? 

Compassion Fatigue: What is it? 

Compassion fatigue (Figley, 1995): emotional residue of exposure to working with the suffering— particularly those suffering from traumatic events 

Parallels PTSD   

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Can be thought of as secondary post-traumatic stress 

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Described nurses worn down from dealing with hospital emergencies “Bearing the suffering of clients” (Figley, 1992) The painful stories of sexual abuse, rape, physical and emotional violence

Vicarious traumatization (McCann & Pearlman, 1990)

Develops over time  

Constant out-putting of caring An accumulation of feeling

Compassion Fatigue: What is it? 

Manifested in one or more ways including      

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Re-experiencing the event Avoidance or numbing Persistent arousal Emotional blunting Physical, emotional and spiritual fatigue or exhaustion Erosion in the ability to feel and care for others

The double-edged sword of empathy (MacEwan, 2005) Permanently change the psychological constructs of workers

There is no “Returning from the Field” 

Large Scale Traumatic Events  Tendency

to just work and work and not take breaks Away from home  Will leave the environment 

 Difference

is that there is a natural tendency to take care of yourself when you return from the field

Signs and Symptoms            

Abusing drugs, alcohol or food Anger Blaming Chronic lateness Depression Diminished sense of personal accomplishment Exhaustion Frequent headaches Gastrointestinal complaints High expectations Hopelessness Hypertension

A Word about Countertransference 

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Countertransference: attributing to the client by the worker, traits and behaviors of past and present significant others or events in the worker’s own life The helping relationship becomes a chore Examples include       

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Extending the session beyond the usual time limit Taking and responding to phone calls at all hours of the night Experiencing hurt feelings over client failures Attempting dramatic cures on impossible cases Becoming angry or bored with clients Losing one’s sense of humor Refusing to withdraw from a case that is beyond the worker’s purview

Countertransference is necessary and transcient

Burnout: How is it different? 

Not easy to define  

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Slow and insidious onset Experienced as a state of emotional, physical and mental exhaustion caused by long-term involvement in emotionally demanding situations Symptoms include physical depletion, feelings of helplessness and hopelessness, disillusionment, negative self-concept, negative attitudes towards work, people and life Stages of burnout    

Enthusiasm Stagnation Frustration Apathy

James and Gilliland, 2001

Part 2: The Organization as the Client 

Burnout should be viewed from a systems perspective and as an organizational problem  The

lack of positive features in the workplace is significantly correlated with burnout  Organizational crises (funding, human resources cutbacks, restructuring) create organizational stress and hostility

How Organizations Cause Personal Stress (Maslach & Leiter, 1997) A

mismatch between the nature of the person doing the work and the job itself Overloaded work schedule  Lack of control  Breakdown in community  Unfair treatment of workers  Conflict of values 

The Responsibility of the Work Environment: The Cost of Caring 

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Relationship between compassion fatigue/high burnout and the ability of the employing organization to recognize or do anything about organizational problems Critical factors include:       

Impact on procedural or policy issues Lack of physical, human and financial resources Autonomy on the job Clarity of organizational mission, goals and objectives/clear communication High intensity of work assignments over long periods of time Restrictions in how clients may be treated Unappreciated by co-workers and supervisors

Problems in Schools       

Size of the system Lack of proactive intervention Vertical integration of programs School governance Diversity Safety Parent participation in schools

At Work: What Leads to Burnout? 

Think about an organization you have worked for and write down some specific behaviors or concrete problems that occurred at work. Answer the following questions in pairs or threes-   

What observable stress did you see in colleagues because of the problem? What stress responses did you have? How could these organizational issues lead to burnout? Picture yourself as an outside consultant. How would you have handled these issues?

Strategies: What Helps at Work?    

Clear mission and purpose Easy access to supportive and positive consultation and supervision Flexibility and emotional support Job clarity and job redesign 

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Reduce rules, regulations and paperwork

Facilitative managers/relational practice Realistic expectations for client progress Help workers solve problems associated with high stress on the job

Simple Examples: Support at Work 

Wellness Committee    

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Monthly retreats/fun days Normalizing activities  

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Massage Weight Watchers Walking groups Lunch and Learns

Painting Golf

Education and Training Employee Assistance Program Human Resources Services    

FMLA Vacations/Sick Leave Flexible schedules Bereavement Leave

Part 3: Development of Skills and Behavioral Plans     

Social support Task focused behaviors Emotional distancing Cognitive self-talk Altruism

Holiday & Smith, 1995

Resources 

APS Behavioral Health  Provides

employee assistance services to the Baltimore City School system

References 

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Eby, L.C. & Wallender, J.L. (2003). School staff and crisis: Care for the caregiver. A Public Entity Risk Institute Symposium. Figley, C. (1992). Compassion factigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. James, R.K. & Gilliland, B. E. (2001). Crisis intervention strategies. Wadsworth Publishing: Stamford, CT. MacEwan, L. (2005). Compassion fatigue. Thompson, R. (2003). Compassion fatigue: The professional liability for caring too much. A Public Entity Risk Institute Symposium. Stamm, B.H. (1997-2005) Professional Quality of Life: Compassion and Fatigue Subscales, R-IV (ProQOL). http://www.isu.edu/-bhstamm What is compassion fatigue? http://www.acenetwork.com

Wrap Up and Questions

Kathleen Beauchesne [email protected] Johns Hopkins Institutions 443-997-7000