Compassion Fatigue: How to identify it and avoid it

1. Compassion Fatigue: How to identify it and avoid it ISANNE conference April 26, 2011 Dr. Will White LCSW, LADC York, Maine

2. Two Thoughts • “One can give nothing whatever without giving oneself, that is to say risking oneself.” -James Baldwin • Compassion means to suffer with.

3. Compassion Fatigue? • Figley (1995) developed the concept after noticing the unique work conditions and experiences of those working with traumatized individuals in the mental health profession and others who assumed the role of caregiver (e.g., families, medical personnel, etc.). • Figley (1998) later described that compassion fatigue manifests after professionals are exposed to secondary trauma, an experience of stress and anguish directly related to the demands of caring for someone who is suffering or has suffered from a traumatic event ⁄ stress.

4. Compassion fatigue is a form of burnout, often experienced by those who work as caregivers in their own families and ⁄ or the human service sector. The term has also synonymously been used to describe secondary traumatic stress. (Salston & Figley, 2003)

5. Burn Out? • Burnout is “a state of physical, emotional, and mental exhaustions caused by long term involvement in emotionally demanding situations.” ( Pine & Aronson, 1988, p. 9) • Countertransference is “seeing oneself in the client, of overidentifying with the client, or of meeting needs through the client”. (Corey, 1991) Yet there are no standard definitions for burnout (Edwards, Burnard, Coyle, Fothergill, & Hannigan, 2000).

6. One Summit Staffer (John D.) referred to Compassion Fatigue as: • Emotional repetitive stress syndrome.

7. Qualifier • Compassion fatigue and Burn out could be confused with depression or dysthymia. • Always rule out physical issues such as thyroid disease that could also look like compassion fatigue.

8. Compassion Fatigue • You know it when you see it in others. • It is a state of mind that impacts the body and soul. • It can lead to poor decision making. • If untreated it could end a career. • It is the unconscious telling the conscious, “You got to take a break.” • If looked at and addressed can lead to a tremendous growth opportunity.

9. Compassion Fatigue • Is an opportunity for personal growth. • Isn’t that what we are all about?

10. Group discussion

11. Signs & Symptoms Trouble sleeping Amplified or exaggerated physical reflex Increase emotional reactivity (irritability and anxiety) Hypervigilance Diminished interests in regular activity. Objectifying clients. Cynicism Hopelessness GI complaints Loss of sense of humor (Figley, 2002b) (Negash, S & Sahin, S, 2011)

12. Organizational factors Role conflict and/or confusion • Lack of decision making authority • Nonprofessional duties • Professional overload • Counselor-teacher professional relationships • Counselor-principal relationships Wilkerson K. and Bellini, J. (2006)

13. Characteristics and traits • Female • School counselors (Wilkerson, 2009).Psychiatrists • Early in career (2-3 years) • Later in career (20-25 years) • Rural psychotherapists (isolated) • Higher rates the higher the caseloads. • An emotionally reactive personality trait • Personal trauma history • Clinicians in the trauma field (Sprang, G. et al 2007)

14. What percentage? • 23% • Of psychotherapists met criteria for compassion fatigue. (Sprang, G et al, 2007)

15. Group discussion

16. Protective factors • Supportive working environments. • Adequate supervision. • Autonomy and control. • Access to sufficient resources. • Education (continuing). • Exercise, preferably Yoga. • Getting enough sleep. • Regularly taking time off (really taking it off). • (Negash, S & Sahin, S, 2011)

17. Conclusion • Those providing mental health services in independent school communities are at high risk for compassion fatigue due to the isolated nature of the work and the challenges of dual roles. • Mental health providers in schools have a unique responsibility of taking care of others. With that responsibility comes the obligation of taking care of self and modeling the behavior for others.

18. Conclusion • We have an obligation to take care of ourselves. • To be the caretakers of communities we need to practice self care skills. • Joan of Arc was burned at the stake only once. • Focus on the positives. • Develop a practice of self care. Do it daily.

19. References • Corey. C.F. (1991). Theory and practice of counseling psychotherapy. Belmont, CA: Brooks Cole. • Edwards, D., Burnard, P., Coyle, D., Fothergill, A., & Hannigan, B. (2000). Stress and burnout in community mental health nursing: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 7, 7–14. • Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Finley (Ed.), • Figley, C. R. (2002a). Treating compassion fatigue. New York: Brunner ⁄ Rutledge. • Figley, C. R. (2002b). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of Clinical Psychology ⁄ In Session, 58, 1433–1441. • Negash, S. & Sahin, S. (2011). Compassion fatigue in marriage and family therapy: Implications for therapists and clients, Journal of Marital and Family Therapy, 37, 1-13. • Pines, A. & Aronson, E. (1988). Career burnout: Causes and Cures. New York: The Free Press. • Salston, M. D., & Figley, C. R. (2003). Secondary traumatic stress effects of working with survivors of criminal • Sprang, G., Whitt-Woosley, A., & Clark, J. (2007). “Compassion Fatigue, Burnout and Compassion Satisfaction: Factors impacting a professional’s quality of life. Journal of Loss and Trauma. 12, 259 - 280 • Wilkerson, K. (2009). An examination of burnout among school counselors guided by stress-strain-coping theory, Journal of Counseling & Development, 87, 428-437.