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Compassion fatigue

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  • #7 …& associated reactions such as panic/anxiety & depression
  • DEPENDS…
  • DEPENDS…
  • DEPENDS…
  • Transcript

    • 1. Compassion Fatigue Secondary Trauma What is it?
    • 2. History  1982: Charles Figley defines SecondaryTraumatic Stress as a phenomenon associated with the “cost of caring”  1992: Nurse Joinson used term in Nursing Magazine to describe feeling of “worn down”  1992: Jeffrey Kottler writes CompassionateTherapy to emphasize importance of compassion when dealing with difficult / resistant clients  1995: Figley redefines SecondaryTraumatic Stress to a “more friendly term” - Compassion Fatigue
    • 3. CF defined:  Those who work with the suffering suffer themselves because of the work  “We absorb the traumatic stress of those we help” (Beaton & Murphy, 1995)
    • 4. AKA Secondary Trauma or Secondary Post-Traumatic Stress or Secondary Exposure or SecondaryVictimization orVicariousTraumatization or Emotional Contagion or Secondary Survivor “Phenomenon associated with the ‘cost of caring’ for others in emotional pain” (Figley, 1982)
    • 5. Compassion Fatigue Secondary Trauma Do I have it?
    • 6. CF “Possible” Solution…
    • 7. Compassion Fatigue Secondary Trauma How did I get it?
    • 8. The CF Process Figley, 2001
    • 9. The CF Process 1. Exposure to Suffering 2. Empathic Concern – motivation to respond to those in need 3. Empathic Ability – aptitude for noticing the pain of others 4. Empathic Response – helper makes an effort to reduce the suffering of the sufferer
    • 10. The CF Process 5. Compassion stress – compulsive demand for action to relieve the suffering of others 6. Prolonged Exposure – on-going sense of responsibility for the care of the suffering 7. Traumatic recollections – memories that trigger the symptoms of PTSD 8. Demands of Life – unexpected changes in schedule, routine, & managing life’s responsibilities that demand attention
    • 11. The CF Process 9. Compassion Fatigue – state of tension and preoccupation with the traumatized by: a. Re-experiencing the traumatic events b. Avoidance/numbing reminders c. Persistent arousal 9. CompassionTrap – inability to let go of the thoughts, feelings and emotions useful in helping another, long after they are useful
    • 12. A Codependen t Co- worker with Compassion Fatigue
    • 13. Compassion Fatigue Secondary Trauma How bad is it?
    • 14. Contributing Factors  Intensity  Frequency  Severity  Proximity  Personal Factors  Sensory Information – “Imprint of Horror” (Learner, 2005)  Perceptions, Belief system  Current coping mechanisms  Implementation of self-care techniques  Support system
    • 15. Symptoms of Poor Self-Care  Cognitive  Diminished concentration  Confusion  Loss of meaning  Decreased of self-esteem  Apathy  Rigidity  Self-doubt  Perfectionism  Minimization
    • 16. Symptoms of Poor Self-Care  Emotional  Powerlessness  Anxiety  (Survivor) Guilt  Anger/rage  Numbness  Fear  Sadness  Helplessness  Depression  Hypersensitivity  Overwhelmed  Depleted
    • 17. Symptoms of Poor Self-Care  Behavioral  Impatient  Withdrawn  Moody  Regression  Sleep Disturbances  Appetite changes  Elevated startled response  Hyper vigilance  Use of unhealthy coping skills  Accident proneness  Losing things  Self-harm behaviors
    • 18. Symptoms of Poor Self- Care  Spiritual  Questioning the meaning of life  Loss of purpose  Lack of self-satisfaction  Pervasive hopelessness  Angry at God  Questioning prior beliefs  “Soul Sick” (Bill O’Hanlon)
    • 19. Symptoms of Poor Self- Care  Interpersonal  Withdrawn  Decreased interest in intimacy  Mistrust  Intolerance  Loneliness  Projection of anger or blame
    • 20. Symptoms of Poor Self- Care  Physical  Shock  Sweating  Rapid heartbeat  Aches and pains  Dizziness  Impaired immune system  Restlessness
    • 21. Impact on Professional Functioning  Performance of JobTasks  Decrease in quality & quantity  Low motivation  Avoidance of job tasks  Increased mistakes  Setting perfectionist standards  Obsession about details
    • 22. Impact on Professional Functioning  Morale  Decrease in confidence  Loss of interest  Dissatisfaction  Negative attitude  Apathy  Demoralization  Lack of appreciation  Detachment  Feelings of incompleteness
    • 23. Impact on Professional Functioning  Interpersonal  Withdrawal from colleagues  Impatience  Decrease in quality of relationship  Poor communication  Staff conflicts
    • 24. Impact on Professional Functioning  Behavioral  Absenteeism  Exhaustion  Faulty judgment  Irritability  Tardiness  Irresponsibility  Overwork  Frequent job changes
    • 25. Compassion Fatigue Secondary Trauma How do I get rid of it?
    • 26. “When you discover you are riding a dead horse, the best strategy is to dismount” - Dakota Tribal Saying
    • 27. ““Primum non nocere”Primum non nocere” - Claudius Galen, born in 129 AD, chief physician to the gladiator school in Pergamum First Do No HarmFirst Do No Harm
    • 28. ““First do no harmFirst do no harm to Self”to Self” - Gentry & Figley, 2007 Created adage after discovering correlation between compassion fatigue and ethical violations
    • 29. Self-Care may involve…  Re-evaluating an unhealthy relationship  Listening to your body & staying within your limits  Advocating for your rights  Commit more time to planning  Not assuming responsibility for others & their problems  Lose “all-or-nothing” thinking; be more flexible  Not feeling compelled to “fix”/solve another person’s problem  Not anticipate the needs of others
    • 30. Self-Care may involve…  Re-think trying to please others; explore being satisfied with self  Appreciate your mistakes – opportunity to learn & grow  Not over-committing  Giving yourself plenty of time so you don’t feel harried or pressured  Quit blaming and shaming self…then others  Stop taking things personally
    • 31. Self-Care may involve…  Keeping up with dentist & doctors appts.  Taking restroom breaks when needed  Accepting myself for who I am  Not feeling the need to control; accept some things are out of my control  Forgive yourself when you make a mistake  Quit trying to prove you’re good enough  Stop tolerating behaviors that you don’t want to tolerate  Trust yourself
    • 32. Compassion Fatigue Secondary Trauma How do I keep it from coming back?
    • 33. Back to the CF Process  Detachment (M. Beattie, 1992)  Opposite of attachment – excessively worried or preoccupied w/ person or problem  It’s Not: Cold,Withdrawn, Hostile, Ignorant Bliss  Based on premise that “each person is responsible for himself & we can’t solve problems that aren’t our own & worrying doesn’t help”
    • 34. Detachment cont.  “It doesn’t mean we don’t care. It means we learn to love, care & be involved without going crazy” (M. Beattie, 1992)  “When we allow people to be who they are, then we stop trying to change things we can’t.” (M. Beattie, 1992)
    • 35. Sense of Satisfaction  “Shades of Gray” (D. Burns, 2005, Cognitive Motivational Therapy)  “When things don’t work out as well as you’d hoped, you can think of the experience as a partial success or learning opportunity.  Question: Are you wanting your client to provide for you a sense of satisfaction?  “You’re OK … then I’m OK”
    • 36. Sense of Satisfaction cont.  Reframe the “Pay-Out”  Appreciation  Approval  Attention  Acceptance  Affiliation  Admiration  Acknowledgement  Affirmation  Accomplishment  Affection
    • 37. Standards of Self-Care 1. Respect for dignity & worth of self 2. Responsible for self-care 3. Universal right to wellness 4. Physical rest, emotional rest & nourishment 5. Seek, find & remember appreciation from supervisors & clients 6. Make it known that you wish to be recognized for your service Adapted from “Standards of Self Care for the Practitioner,” Green Cross Foundation, Inc., 2004