Supporting Heroes: Mental Health Training for Those Exposed to Child Pornography

1. Module 1: Introduction and History 5 minutes

2. SHIFT: Supporting Heroes In mental health Foundational Training Helping Those Exposed to Child PornographyA Psychoeducational Program for Exposed Individuals

3. funded byDepartment of Justice, OJJDPICAC Training & Technical Assistance This project was supported by Grant No. 2009-SN-B9-K063 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.

4. Course developed by Jane Stevenson (Workplace Wellbeing) Chuck Arnold (ICAC Task Force Commander) Mike Sullivan (ICAC Task Force Commander) Joe Laramie (ICAC Task Force Commander) in partnership with The Innocent Justice Foundation

5. Huntsville PEP-EIYour Trainers are Jane Stevenson, Mental Health Professional andJoe Laramie, Law Enforcement Professional

6. Objectives of this Session Understand Negative Effects How to Cope and Build Resiliency Developing Workplace Support Working with a Mental Health Professional Encouraging Friend and Family Support Self-care Techniques

7. Pre- Test Delivery 5 minutes

8. Module 3: Physiological Effects and Symptoms of Chronic Exposure 30 minutes

9. Physiology of Stress Stressors - Acute - Chronic Hypothalamus Adrenaline Cortisol Noradrenaline Our physiological response will depend on the severity of the stressor and the duration of the stress

10. Acute Physiological Effect Triggered by acute events such as being attacked: Sympathetic nervous system(noradrenaline) Sympathetic adrenal medulla (adrenaline) Blood vessels dilate • Blood pressure and heart rate increase • We are ready to fight …..or flee

11. Chronic Physiological Effect Chronic exposure to stressors can be responsible for a cumulative psychological impact. • Chronic stressors may lead to high levels of circulating cortisol. • Cumulative exposure to stressors can lead to • Burnout • Compassion Fatigue • Vicarious Trauma

12. Chronic Physiological Stressors • Chronic stressors for ICAC staff may include High workloads Exposure to distressing images Emotional interaction with child victims and/or offenders Resulting sense of hopelessness

13. Burnout Often excessively dedicated employees According to Luban (1996), “Burnout” tends to happen to givers -- people who are the bright, perfectionist, idealistic high achievers in our culture.”

14. Compassion Fatigue Stamm & Figley, 1996 • Reduction in Compassion Satisfaction: • Increased negative emotionality • Low morale and apathy • Dissatisfaction about one’s role as helper Helping the Helpers: The Safeguard Program at the National Center for Missing and Exploited Children, Juliet M. Francis, Psy.D., Gina De Arth-Pendley, Ph.D., Erin Reilly, M.A., Christine Feller, M.A., and John Shehan,

15. Vicarious Trauma Definition “ .. the cumulative transformative effect upon the (exposed individual), of working with survivors of traumatic life events” EMPATHIC ENGAGEMENT: Pearlman & Saakvitne (1995)

16. Vicarious Trauma (VT) VT is a process of change relating to how an individual views themselves and the world around them Gradual process Often insidious Can include compassion fatigue Can include burnout Can be permanent Can be stopped!

17. Range of Trauma Primary Secondary Viewing CP images Interviewing a suspect Interviewing a victim UC as a mother/child UC as offender Case triage

18. Symptoms of Chronic Exposure Normal non-persistent non-intrusive Warning Signs persistent mildly intrusive Trouble Indicators persistent intrusive

19. Traditional Coping Strategies Simple Denial Rationalization Sublimation Reframing negative affect as being overworked or other conventional forms. *Durham, McCammon & Allison, (1985), †Janik (1995)

20. Video: EI talks about trying to deny

21. Maladaptive Coping Strategies Risk-taking behavior Driving too fast or angrily Alcohol abuse Substance abuse Affairs Workaholism *Durham, McCammon & Allison, (1985), †Janik (1995)

22. Physiological Effects Physical Response to Images

23. Module 4: Professional Factors, Management Response, and Personal Factors 15 minutes

24. Factors Influence Symptoms Professional Factors Personal Factors

25. Professional Factors Type of Work Job Itself • Killing a human • Death of a fellow officer • Being attacked • Direct contact with child abuse* Anshel, M.H. (2000)Follette et. Al (1994)

26. Professional Factors Type of Work Large caseloads, low success rate, lack of reward Lack of tools and training Images with strong emotional content Heightened empathy for the victims Images that precipitate familiarity with loved one Lack of understanding of role by society

27. Video: EI talks about caseload, tools, training

28. Highest Higher Lower Under 1 year 1-4 years 4+ years Professional Factors Length of Time on Job Helping the Helpers: The Safeguard Program at the National Center for Missing and Exploited Children, Juliet M. Francis, Psy.D., Gina De Arth-Pendley, Ph.D., Erin Reilly, M.A., Christine Feller, M.A., and John Shehan,

29. Professional Factors Cumulative Exposure Lack of breaks from exposure Degree of Organizational Support Isolation* Peer respect Command support No way out* Mental Health Services *George A Bokelberg, Psy.D., Supervisory Special Agent, Federal Bureau of Investigation, Stress Associated with Investigating and Working in Support of Investigations of Internet Sexual Crimes Against Children

30. Management Response “Few agencies seemed to plan for the possiblity that some personnel might have problems due to exposure to child pornography.” Work-Related Exposure to Child Pornography in ICAC Task Forces and Affiliated Agencies: Reactions and Responses to Possible Stresses, Janis Wolak , Kimberly J. Mitchell, UNH Crimes Against Children Research Center, Conducted for U.S. Dept of Justice, OJJDP, 2009

31. Need for More Support Research by Jane Stevenson, UK, 2002 60% of British officers felt inadequately briefed for role Found their role to be more distressing than expected 21% “Identifying effective support for police officers and support staff, viewing child abuse images on the Internet,” Jane Stevenson. BSc (Hons), Occupational Health and Welfare

32. Lack of Preparation Survey by University of New Hampshire, 2009 19% Affiliates prepared incoming staff ICAC’s prepared incoming staff 45% Work-Related Exposure to Child Pornography in ICAC Task Forces and Affiliated Agencies: Reactions and Responses to Possible Stresses, Janis Wolak , Kimberly J. Mitchell, UNH Crimes Against Children Research Center, Conducted for U.S. Dept of Justice, OJJDP, 2009

33. Management Response Survey by University of New Hampshire, 2009 75% Of ICAC Task Force personnel saw the need for more psychological resources Of ICAC Administrative personnel were not concerned about the effects of exposure to CP. 50% Work-Related Exposure to Child Pornography in ICAC Task Forces and Affiliated Agencies: Reactions and Responses to Possible Stresses, Janis Wolak , Kimberly J. Mitchell, UNH Crimes Against Children Research Center, Conducted for U.S. Dept of Justice, OJJDP, 2009

34. Poor Mental Health Support Survey by University of New Hampshire, 2009 13% Of ICAC affiliates felt mental health staff was knowledgeable about cp Of ICAC Task Forces felt mental health staff was knowledgeable about cp 33% Work-Related Exposure to Child Pornography in ICAC Task Forces and Affiliated Agencies: Reactions and Responses to Possible Stresses, Janis Wolak , Kimberly J. Mitchell, UNH Crimes Against Children Research Center, Conducted for U.S. Dept of Justice, OJJDP, 2009

35. Poor Mental Health Support “I have gone to our agency sponsored EAP (Employee Assistance Program) on my own, not with any problem, just to try to start a rapport with them and maybe set up a schedule for them to evaluate us. They basically told me that if I didn’t have any real problem they couldn’t help.” --Law Enforcement Supervisor

36. Video: EI talks about not being prepared for job

37. Personal Factors Heightened empathy for the victims Home-Life Stress Personal relationship stress* Bringing work home Lack of outside interests *George A Bokelberg, Psy.D., Supervisory Special Agent, Federal Bureau of Investigation, Stress Associated with Investigating and Working in Support of Investigations of Internet Sexual Crimes Against Children

38. Personal Factors Unresolved personal or family sexual abuse Being a parent Custody battles Illness or death of child Difficulty getting pregnant George A Bokelberg, Psy.D., Supervisory Special Agent, Federal Bureau of Investigation, Stress Associated with Investigating and Working in Support of Investigations of Internet Sexual Crimes Against Children

39. Module 5: Resiliency and Coping 10 minutes

40. The Good News It is possible: to prevent and mitigate negative effects of exposure to increase professional and personal satisfaction

41. Factors that Reduce Harm Feelings of Empowerment • Catching the bad guys Helping truly innocent victims • Preventing further children from being abused

42. Factors that Reduce Harm Compassion Satisfaction: • Satisfaction with care giving ability • Feeling pleased to help others • Positive feelings towards colleagues • Positive feelings about ability to help, contribute Helping the Helpers: The Safeguard Program at the National Center for Missing and Exploited Children, Juliet M. Francis, Psy.D., Gina De Arth-Pendley, Ph.D., Erin Reilly, M.A., Christine Feller, M.A., and John Shehan

43. Factors that Build Resiliency Feeling part of a group Social support Outside interests and hobbies Training and awareness Exposed individual Mental health professional Family and friends Seeking help when needed

44. Personal Responsibility Taking a Pro-active approach critical: For ourselves To benefit family and friends To improve work atmosphere Coworkers ICAC team Affiliate agency

45. Video: EI talks about how came back from the brink and saved job and family

46. Break 15 minutes

47. Module 6: Developing Workplace Strategies to Maintain Mental Health 20 minutes

48. Educating Colleagues-Command Feeling Empowered to Coach and Educate Not complaining Method to improve situation for all Use tools Ask mental health professional to advocate Slowly, within reason – takes time

49. Tools to Use Feeling Empowered to Coach and Educate Video Protocol Handout Mental Health Professional Training Sessions Research Guidelines

50. Video 10 minutes