Secondary Traumatic Stress and the Child Welfare Professional

Secondary Traumatic Stress and the Child Welfare Professional Preparation for UPP students Adapted from Josephine G. Pryce, David H. Pryce, and Kimberly K. Shackelford (2007)

UPP Seminar • STS • Session I • Session II • Session III • Emotional Intelligence • Goleman • Journal • Resource Manual • Personal and Professional

Purpose • As a child welfare professional, caring for others in distress is an integral part of the job. • Caring also carries with it certain costs in terms of our mental and physical health and our general well-being. • Learning to cope with the emotional costs of our work is the theme of this seminar. • Purpose: The purpose of this seminar is to increase your awareness of the emotional costs associated with child welfare work and how to reduce their effects.

Session I: Goals and Objectives • Goals: to increase knowledge of secondary traumatic stress and its effects on child welfare professionals (UPP students) • Objectives: • To understand concepts related to traumatic stress and how it differs from burnout • To understand the five categories of human response to trauma and the consequence of each • To better understand the unique relationship between the child welfare worker and the traumatized client

Primary Posttraumatic Stress (PTS) • An array of normal human responses following direct exposure to one or more traumatic events, i.e, natural disasters, acts of extreme violence such as combat, life-threatening physical assault, or rape. • May result from trauma experienced as an adult or in childhood • May be immediate or may occur long after the event.

Secondary Traumatic Stress (STS) • A form of posttraumatic stress that is the result of indirect exposure to trauma that arises from a relationship with a traumatized client. • Is a typical human response • Comes from our perceptions of the client’s traumatic experience • Can worsen and become debilitating if ignored or unattended • Sometimes referred to as vicarious traumatization or compassion fatigue

Trauma/Burnout Exercise • Subject: differentiating between traumatic stress and burnout • When I hear the word “trauma” I automatically think: • A burned out child welfare professional is:

Burnout • Irritability and general distrust of others’ intentions • No new ideas in the past six months • Lack of energy – physical or emotional • Feelings of isolation and lack of personal support • Overwhelming urge to leave the work • Attempts to feel good about oneself by focusing on how much one does rather than the quality of work completed

Burnout verses STS • Burnout • Is characterized by emotional exhaustion, develops gradually, worsens as time passes, is associated with high stress and low personal reward, is situational and common is some work environments • STS • Emerges suddenly, either soon or long after trauma, is characterized by unpleasant memories of an intrusive nature, is characterized by feelings of helplessness, confusion, and social isolation, is based in the helper-client relationship

Distinguishing between STS and PTS • Read the index cards • Distinguish whether the incident is secondary or primary trauma

How do humans respond to trauma? • Emotional • Cognitive • Biological • Behavioral • Interpersonal

Emotional • Fear and anxiety • Depression • Lowered self-esteem or identity problems • Anger • Guilt and shame • Numbing (loss of emotional feelings)

Cognitive • Intrusive mental activity • Flashbacks • Nightmares • Intrusive recollections • Perceptual disturbances • Dissociation (altering of consciousness) • Depersonalization • Memory loss • Decrease in attention span • Decrease in intellectual functioning

Biological • Hyper-arousal (hyper-vigilance and hyper-atlertness) • Somatic disturbances • Sleep disruption

Behavioral • Aggressive and antisocial behaviors • Suicidal behaviors • Substance abuse • Impaired social functioning • Personality changes • Isolation

Interpersonal • Feelings of estrangement from others • Loss of intimacy • Sexual problems • Re-victimization • Victim becomes victimizer

Constructivist Self Theory • Self diagram Intimacy Safety Trust and Dependency Power and Esteem Independence

Intimacy Safety Trust and Dependence Trauma Independence Power Esteem Cope Adapt Support Dump Your Bucket Birth to 12 12 to 22 Partner Career (CPS) Early Investigation Guilt and Shame Nightmares Headaches Substance use Aggression 22 to 25

Transference: Client • Client System may: • View all authority, including caseworker, with distrust • View situation as one of life or death, and the caseworker as omnipotent rescuer • View caseworker as a person who is contributing to the trauma and resist necessary change • Caseworker must understand that traumatized individuals have a distorted worldview and act accordingly

Counter-transference: Caseworker • Trauma can be contagious. Therefore, the caseworker may • Experience the same sort of terror, helplessness, and rage as the client (all typical human responses) • Begin to feel distrustful and cynical • Doubt his or her own ability to assist with helping to solve the client’s problem • Set up his or her own psychological defenses to counter feelings (i.e. numbing) or have feelings of grandiosity or omnipotence (belief that he or she has the ability to know all, love all, heal all) • The cruel twist: the more empathetic the worker is, the more he or she is subject to STS.

Secondary Traumatic Stress Session II

Session II: Goals and Objectives • Goal • To increase knowledge of individual coping skills that can reduce the effects of STS • Objective • To understand personal vulnerability • To learn to balance the needs of client, agency, and self • To understand the role of supervisor • To recognize when one’s self-care system is not working • To recognize positive and negative coping behaviors

Movie “Reign On Me” • Physical • Social • Emotional • One’s personal history of trauma and healing

Self-Assessment: Personal Coping Skills • Physical • Sleep, nutrition, exercise • Social • Support, getting help, activism • Emotional • Life balance, spirituality, relaxation, humor, contact with nature, self-expression • One’s personal history of trauma and healing • Life book • Diary

Self-Assessment: Professional Coping Skills • Workload balance • Boundaries or limits • Availability of support • Professional development • Job committment

Supervision • The supervisor provides a different perspective • Active supervision • Listening • Guiding • Full range of communication including both emotions and cognitions • Help to access assistance and services • The supervisor-caseworker relationship is reciprocal

Signs: Self-care is NOT working • Staying numb or in denial for longer than average after exposure to a traumatic stressor • Feeling detached from others • Seeing others as objects rather than as human beings with thoughts and feelings that deserve consideration • Loss of empathy • Deterioration of personal and professional relationships • Loss of personal and professional effectiveness

Coping Behaviors • Positive • Actively seeking supervision and support • Supporting colleagues with their own coping issues • Staying physically and mentally fit • Maintaining a strong social support system • Negative • Failing to practice positive coping skills • Escaping through substance abuse, reckless thrill seeking, or risky sexual encounters

Negative Thinking patterns • Filtering • Polarized • Overgeneralization • Mind Reading • Catastrophizing • Personalization • Control Fallacies • Fallacy of Fairness • Emotional Reasoning • Fallacy of Change • Global Labeling • Blaming • Shoulds • Being Right • Heaven’s Reward Fallacy

Thinking Filtering: You take the negative details and magnify them while filtering out all positive aspects of the situation. Polarized: Things are black and white, good or bad. You have to be prefect or you are a failure. There is no middle ground. Overgeneralization: You come to a general conclusion based on a single incident or piece of evidence. If something bad happens once, you expect it to happen again and again. Mind Reading: Without their saying so, you know what people are feeling and why they act that way. In particular, you are able to divine how people are feeling about you.

Thinking Catastrophizing: You expect disaster. You notice or hear about a problem and start "what ifs:" "What if tragedy strikes? What if it happens to you?" Personalization: Thinking that everything people do or say is some kind of reaction to you. You also compare yourself to others, trying to determine who's smarter, better looking, etc. Control Fallacies: If you feel externally controlled, you see yourself as helpless, a victim of fate. The fallacy of internal control has you responsible for the pain and happiness around you. Fallacy of Fairness: You feel resentful because you think you know what is best but other people will not agree with you.

Thinking Blaming: You hold other people responsible for your pain, or take the other tack and blame yourself for every problem or reversal. Shoulds: You have a list of ironclad rules about how you and other people should act. People who break the rules anger you and you feel guilty if you violate the rules. Emotional Reasoning: You believe that what you feel must be true ~ automatically. If you feel stupid and boring, then you must be stupid and boring. Fallacy of Change: You expect that other people will change to suit you if you just pressure or cajole them enough. You need to change people because your hopes for happiness seem to depend entirely on them.

Thinking Global Labeling: You generalize one or two qualities into a negative global judgment. Being Right: You are continually on trial to prove that your opinions and actions are correct. Being wrong is unthinkable and you will go to any length to demonstrate your rightness. Heaven's Reward Fallacy: You expect all your sacrifice and self-denial to pay off, as if there were someone keeping score. You feel bitter when the reward doesn't come.

Secondary Traumatic Stress Session III

Session III: Goals and Objectives • Goal • To increase knowledge of social support and how it can help to reduce the effects of STS • Objective • To better understand what social support is • To understand how social support can help with STS • To learn how to use social support • To understand roles of support seeker and support provider and how they are important to the social support network

Social Support Systems (Networks) • Size • Member roles • Relationship quality

Social Support • Emotion Focused • Oriented toward feelings • Problem Focused • Oriented toward problem solving

Getting Social Support • Actively Ask For IT! • Passively Act Like You Need IT! • Giving emotion-focused social support • Support • Escape

Giving Emotion-Focused Social Support • Supporting Behaviors • Affirming the support seeker’s ability • Giving affection • Providing a time-out • Giving a gift • Telling the support seeker everything is okay • Making sympathetic remarks • Telling a joke to make him or her laugh • Laughing with him or her • Doing something funny

Giving Emotion-Focused Social Support • Escape Behaviors • Talking about what interests you rather than the support seeker • Talking about the helper’s task • Talking about another topic • Ignoring the support seeker • Reading a magazine • Leaving the room • Telling the support seeker to get over it

Giving Emotion-Focused Social Support • Solving Behaviors • Asking the person what’s on his or her mind • Asking questions about the problem • Making suggestions • Dismissive Behaviors • Making fun of his or her problem • Telling the support seeker his or her problem is not serious • Laughing when the other person is not • Talking about your own problems

Responsibility of Self-Care • Saakvitne and Pearlman (1996) assert, “Self-care is an ethical imperative. We have an obligation to our clients-as well as to ourselves, our colleagues, and our loved ones-not to be damaged by the work we do.”

Secondary Traumatic Stress and the Child Welfare Professional