Replenishing the Wellspring: Exploring Counselor Wellness and Resiliency

1. Replenishing the Wellspring: Exploring Counselor Wellness and Resiliency Presented by Elizabeth Venart (2008) Power Point information developed by Elizabeth Venart and the American Counseling Association’s Task Force on Counselor Wellness & Impairment

2. Replenishing the wellspring Introduction • Background • ACA Taskforce on Counselor Wellness & Impairment • Program focus on interaction and reflection

3. Agenda • Why we need well counselors • Risk factors for helping professionals • Research on counselor wellness • Assessment tools • How counselors can enhance their wellness • Organizational considerations • New York’s Counselor ImpairmentProgram

4. Replenishing the wellspring • What is meant by counselor wellness and resiliency? • Why is it essential that we prioritize our own wellness—as counselors and substance abuse professionals?

5. Why is wellness important for counselors? “It is not possible to give to others what you do not possess” (Corey, 2000)

6. Why is wellness important for counselors? • Counselor effectiveness depends more on the personal characteristics of counselors than on school, training, or theory (Hanna, & Bemak, 1997) • Personal wellness, therefore, has an impact on counselor effectiveness with clients (Skovholt, 2001).

7. Wellness defined • “Wellness is the hallmark characteristic of those whose lives achieve the balance between self, life, and others”—Witmer & Granello 2005 • “Wellness is both . . . an overarching goal for living and a day-by-day, minute-by-minute way of being”—Myers & Sweeney 2005

8. Why Wellness Is an Issue • Well-counselors are more likely to produce well-clients • Modeling • Better able to Connect • More attentive to emotional and cognitive content • More energy and creativity in session • Less likely to violate boundaries

9. What is wellness? • Analogy of the well • A well sustains itself with a continuous flow of water when it has sources and is regularly replenished (Milsum, 1984). The amount of reserve is a far more significant indicator of a healthy water supply than the force of water at any given moment. Without a reserve, the well dries up quickly and is no longer able to sustain. Well human beings must have reserves because overall wellness depends far more on these reserves than on performance at any given moment (Milsum, 1984).

10. Replenishing the wellspring • What replenishes your wellspring and sustains your resiliency? • What helps to fill your reserve? • What do you do to unwind at the end of the day? • What brings you satisfaction and joy? • What helps you derive meaning from your work?

11. Definition of impairment Therapeutic impairment occurs when there is a significant negative impact on a counselor’s professional functioning which compromises client care or poses the potential for harm to the client. Impairment may be due to: • Substance abuse or chemical dependency • Mental illness • Personal crisis (traumatic events or vicarious trauma, burnout, life crisis) • Physical illness or debilitation

12. Impairment in and of itself does not imply unethical behavior. Such behavior may occur as a symptom of impairment, or may occur in counselors who are not impaired.

13. Counselors who are impaired are distinguished from stressed or distressed counselors who are experiencing significant stressors, but whose work is not significantly impacted. Similarly, it is assumed that an impaired counselor has at some point had a sufficient level of clinical competence, which has become diminished as described above.

14. Wellness Spectrum Well Stressed Distressed Impaired

15. Models of Wellness: A Holistic Focus • Professional Wellness involves: • Balance • Boundaries/Limit setting • Getting support • Strategies for coping • Professional training • Evaluation of own healing • Replenishment

16. Models of Wellness: A Holistic Focus • Environmental (Work Setting) Wellness involves: • The Physical work setting • Value system of work place • Job tasks & Personnel Guidelines • Supervisory/Management support • Collegiality

17. Special Risks Challenges to WellnessSkovholt 2001 • Our inability to say no-The treadmill effect • Living in an Ocean of Emotional Stress • Ambiguous Professional Loss-Ending before the Ending • The Covert Nature of the Work • Constant Empathy, Interpersonal Sensitivity, and One-Way Caring

18. Special RisksChallenges to Wellness Skovholt 2001 • Elusive Measures of Success and Normative Failure • Regulation, Oversight and Control by External, Often Unknowing Others • Cognitive Deprivation • Cynical, Critical, Negative Colleagues and Managers • Legal and Ethical Fears

19. Special RisksChallenges to Wellness Skovholt 2001 • Cognitive Deprivation • Cynical, Critical, Negative Colleagues and Managers • Legal and Ethical Fears • Practitioner Emotional Trauma • Practitioner Physical Trauma

20. Individual and Systemic Barriers Unreasonably Large Caseloads Large percent of clients with trauma Large percent of clients with high risk behaviors Administrative Supervision (as opposed to Clinical Supervision)Current policies interfere with doing what is best for clients Denial of negative impact of work—or fear of negative evaluation by others

21. When Wellness is Eroded Burnout Compassion Fatigue Vicarious Traumatization

22. BurnoutMaslach, Jackson, & Leiter, 1996 • Emotional exhaustion, depersonalization & reduced feelings of personal accomplishment • Typically attributed to work environment or job choice • Vacation or a job change helps considerably

23. Compassion fatigueFigley 1995 • “A function of bearing witness to the suffering of others” • Feeling deep sympathy for another’s suffering—and a desire to alleviate the pain • Professional Quality of Life Assessment (ProQOL)—www.proqol.org

24. Vicarious Traumatization Experiencing the trauma our clients have suffered, or recalling our own past traumas due to the exposure through our clients. Pearlman and Saakvitne, 1995

25. Vicarious traumatizationPearlman & Saakvitne 1995 • Changes in the self of the helper as a result of empathic connection with the pain of those who have been traumatized • Special focus on changes in meaning • Inevitable • Unique • Cumulative • Modifiable

26. When Wellness is Eroded And then the most insidious of challenges…. LIFE

27. What We Know About Counselor Impairment from the ACA Task Force’s Research • Survey of the ACA Membership Most counselors have known a counselor they would consider impaired (63.5%)In those cases Supervisors (54.3%) and Colleagues (64.2%) were also aware of the impairmentIn most cases the impaired counselor did not receive disciplinary (77.8%) action or therapeutic intervention (73.7%)

28. Wellness Spectrum Well Stressed Distressed Impaired When asked about their own wellness ACA members reported: 81% - Well 15% - Stressed 4% - Distressed 0% - Impaired

29. Wellness Spectrum Well Stressed Distressed Impaired When asked about their colleagues wellness ACA members reported: 47% - Well 33% - Stressed 12% - Distressed 4% - Impaired

30. Counselor Caseloads

31. Percent of Caseloads that is High-risk

32. Professional Quality of Life Burnout – Global Mean 18.37, was significantly LOWER than the published norm (22) Compassion Fatigue – Global Mean 10.05 was significantly LOWER than the published mean (13) AND The Global Mean for Compassion Satisfaction (39.84) was significantly HIGHER than the published mean (37).

33. Professional Quality of Life 14.2% of counselors scored below the cut score (32) for Compassion Satisfaction 5.2% of counselors scored above the cut-point (28) for Burnout 10.8% of participants scored above cut-point (17) for Compassion Fatigue/Vicarious Traumatization

34. Maintaining Counselor Wellness Support Through Personal Counseling 83% of counselors have sought personal counseling

35. Career Sustaining Behaviors Top 5 CSBs Maintain sense of humor Spend time with partner/family Maintain balance between professional and personal lives Maintain self-awareness Maintain sense of control over work responsibilities

36. Career Sustaining Behaviors Bottom 7 CSBs Discuss work frustrations with spouse/partner/family Engage in formal relaxation activities Receive regular clinical supervision Participate in personal therapy Participate in peer support groups Discuss work frustrations with friends Use substances to relax.

37. Career Sustaining Behaviors CSBs Practiced by the Most Satisfied Counselors Reaching Out Participate in personal therapy Discuss work frustrations with friends Participate in peer support groups Receive regular supervision

38. Career Sustaining Behaviors CSBs Practiced by the Most Satisfied Counselors Finding Support Internally and Externally Maintain professional distance from clients Discuss work frustrations with colleagues Seek case consultation Maintain regular contact with referral networks Engage in quiet leisure activities Turn to spiritual beliefs Spend time alone in self reflection Use positive self talk

39. Career Sustaining Behaviors CSBs Practiced by the Most Satisfied Counselors Staying Current and Seeking Renewal Read literature to keep up-to-date Participate in continuing education Discuss work frustrations with spouse/partner/family Take regular vacations

40. Career Sustaining Behaviors CSBs Practiced by the Most Satisfied Counselors Striving for Perspective Perceive clients problems as interesting Discuss work frustrations with spouse/partner/family Discuss work frustrations with friends.

41. Work Related Strategies Read literature to keep up to date Participate in continuing education Maintain professional identity Maintain sense of control over work responsibilities Try to maintain objectivity about clients Perceive clients' problems as interesting

42. Wellness defined • “Wellness is the hallmark characteristic of those whose lives achieve the balance between self, life, and others”—Witmer & Granello 2005 • “Wellness is both . . . an overarching goal for living and a day-by-day, minute-by-minute way of being”—Myers & Sweeney 2005

43. Assessing Wellness Professional Quality of Life http://www.isu.edu/~bhstamm/documents/proqol/ProQOL_vIV_English_Oct05.htm 5F-Wellness Evaluation of Lifestyle www.mindgarden.com

44. Wellness Strategies Across Domains Physical Cognitive Emotional Social Spiritual Balance

45. Physical Wellness • Good nutrition • Exercise—Finding activities you enjoy • Routine medical care • Adequate sleep • Movement/stretching during the day

46. Physical Wellness • The impact of stress on physical health • Strategies to reduce stress • Deep breathing • Meditation • Setting limits

47. Cognitive Wellness Definition from Travis & Ryan (2004): • The individual’s capacity for insight, intelligent thought, and creative problem-solving. • Awareness of one’s thoughts and the interrelationship between thinking and perception, feelings, body states, and behavior. • Ability to focus and concentrate, think affirming thoughts, and transform counter-productive thinking patterns.

48. Cognitive wellness • Identifying self talk • Countering counter-productive internalized messages • Addressing perfectionism • Learning to be kind to ourselves

49. Cognitive wellness • Calming one’s mind • Engaging one’s mind • Reading professional literature • Taking a course • Hobbies • Travel • Getting perspective

50. Cognitive wellness • Celebrating successes • Noticing small positives • Sharing victories in supervision • Keeping a success journal • Creating a “thank you” folder/file