27/03/2015 Bravehearts Trauma For Practitioners: Looking After Us • Bravehearts’ mission: To stop child sexual assault in our society. • Bravehearts’ vision: To make Australia the safest place in the world to raise a child. • Bravehearts’ guiding principles: To, at all times, do all things to serve our Mission without fear or favour and without compromise and continually ensure that the best interests and protection of the child are placed before all other considerations. Jessica Perring Educational and Developmental Psychologist B Psych (Hons). M Psych (Ed and Dev) Vicarious Trauma Vs Burnout Vicarious Trauma • Results from exposure to others’ traumatic stories • Results from working with traumatised individuals • Refers to negative changes in inner experience • Traumatic reaction; can experience trauma symptoms. Burnout • Results from work environment stress such as work overload, insufficient rewards. • Results from working with any client group • Refers to emotional symptoms however doesn’t result in changes in inner experience such as spirituality. • General psychological stress. Symptoms • Sleep difficulties such as nightmares • Flashbacks or repeated thoughts or images of traumatic material • Changes in beliefs or views – views of trust/safety; beliefs regarding spirituality. • Numbness • Avoidance • High absenteeism • Dissociation or zoning out • Feeling hypervigilant or on edge • Irritability and anger • Lack of self-care Symptoms • Difficulty managing your emotions • Difficulty making good decisions and or meeting deadlines • Problems managing boundaries – taking on too much; trying to step in and control other’s lives (disempowering clients); trouble leaving work; difficulty balancing work and home life • Problems in relationships • Physical problems – illnesses, accidents, aches and pains • Difficulty feeling connected to what is going on around you • Difficulty engaging with clients, reduced empathy • Loss of meaning and hope • Feeling helpless or powerless Assessments • Compassion Fatigue Self-test – www.myselfcare.org (Dennis Portnoy, 1996) • Professional Quality of Life Scale (ProQOL) www.proqol.org (Hudnall Stamm, 2009) • Are you showing signs of burnout? – www.headingtoninstitute.org • How Stressed are you? - www.headington-institute.org • Self care and lifestyle balance inventory www.headington-institute.org • Trauma and Attachment Belief Scale (TABS) (Pearlman, 2003) • Impact of Event Scale – Revised (Weiss & Marmar, 1995) 1 27/03/2015 Prevention of VT Relaxation • • • Escape – taking time off, books/films, talking to friends/family about things other than work. • Rest – things that are relaxing, getting a massage, sitting down with a cup of tea. • Play – activities that make you laugh, play with kids, be creative, physically active. Progressive Muscle Relaxation: Muscle tension is associated with stress. This type of relaxation involves gradually tensing and relaxing each muscle group: – – – – • Feet & Legs Stomach Arms & Hands Shoulders & Face Tip: squeeze each muscle for a count of 3. “The capacity to live by our deepest values depends on regularly reviewing our spirit – seeking ways to rest and rejuvenate and connect with the values we find most inspiring and meaningful” (Loehr & Schwartz) Be Present Get Active • “Being Healthy Means Having An Awareness Of How To Get The Most Out Of Your Body Both Physically And Mentally. It’s Not A Trend Or A Diet, But A Lifestyle” - Jason Dundas. Nourish your Body • “We are indeed much more than what we eat; but what we eat can nevertheless help us to be much more than what we are” Adelle Davis Social Connection • • • • • Debrief Supervision Ask for Help Ring a friend Schedule time and activities with family and friends “Friendship makes prosperity more shining and lessens adversity by dividing and sharing it” Marcus Cicero 2 27/03/2015 Time Out Pleasant Activities • Self Care is Not about Self Indulgence, It’s About Self-Preservation – Audrey Lorde • What makes you laugh? • Hobbies • Camping • Road trips • Observing nature • Gardening • Board games • Holidays • Games • Family fun • Only in quiet waters do things mirror themselves undistorted. Only in a quiet mind is adequate perception of the world Hans Margolius Photography Painting Drawing Jewellery making Craft afternoon with kids Sewing Gardening Dancing Pinterest Writing in a journal Collage Play an instrument Try a new recipe or decorate a cake Work/Life Balance: • Take a lunch break • Don’t bring work home • Create a buffer between work and home (e.g. music while driving home) • Limit the time you spend with people who tend to drain your energy • “Art washes away from the soul the dust of everyday life” Pablo Picasso Get Outside • A 7 year old girl wrote the following after her teacher instructed the class to list the 7 wonders of the world: ‘seeing, hearing, tasting, touching, running, laughing, loving’ Lists to Live By (Gray, Stephens, Van Diest) • • • • • • Benefits of Sunlight: Helps the quality and length of our sleep which reduces fatigue Boosts vitamin D Helps immune system functioning Strong bones Increases endorphins (feelgood hormones) Get a massage Listen to music Take a bath Gardening Turn off electronics Balance Get Creative • • • • • • • • • • • • • • • • • • Boundaries: • Help when you can, but consciously try not to take on other people’s problems • Remember what you can do in your role, try not to take on extra responsibilities Organisational Strategies • • • • • • • • • • • • • Take a lunch break Take annual leave Debrief Peer support supervision Encourage connection among workers – team approach, team building activities with a social component. Observe your staff/colleagues – check in and don’t necessarily wait for them to come to you. Varied tasks at work Professional development opportunities Self-care program Managers setting a good example and modelling healthy work habits! ☺ Personally meaningful items on your desk Good news stories – share positive stories in team meetings. 3 27/03/2015 • • • • • • • • • Barriers Overcoming Barriers Bravehearts VT prevention Plan Vicarious Trauma Prevention Plan My Risk Factors: Fortnightly supervision Organisational culture Annual Retreat Monthly counsellor meetings Team self-care Lunch breaks Professional development opportunities – research review; case presentation; allocated budget Varied tasks within role Self-care boxes • – List 5 risk factors (Personal – e.g. personal history, work style, current life circumstance; situation – e.g. role, work setting; culture – e.g. society attitudes, beliefs about receiving help) • My Warning Signs: – List 5 warning signs (signs and symptoms I have noticed in myself – e.g. difficulty meeting deadlines; irritable; tired, nightmares) • My Strategies: – List 5 strategies that you will utilise practice and References • • • • • • • • • • • • • Bell, H., Kulkarni, S. &Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in Society: The Journal of Contemporary Human Services, 84, p. 463-470. Bober, T. &Regehr, C. (2005). Strategies for reducing secondary or vicarious trauma: Do they work? Brief Treatment and Crisis Intervention, 6, p. 1-9. Canfield, J. (2005). Secondary traumatization, burnout, and vicarious traumatization: A review of the literature as it relates to therapists who treat trauma. Smith College Studies in Social Work, 75, p. 81101. Dombo, E.A & Gray, C. (2013). Engaging spirituality in addressing vicarious trauma in clinical social workers: A self-care model. Social Work and Christianity, 40, p. 89-104. Everly, G. S., Boyle, S. H. & Lating, J. M. (1999). The effectiveness of psychological debriefing with vicarious trauma: A meta-analysis. Stress Medicine, 15, p. 229-233. McKay, L. (2009). Peace by Piece, Series 1: The basics. Headington Institute: Pasadena, CA. McKay, L. (2009). Peace by Piece, Series 3: Spirituality. Headington Institute: Pasadena, CA. Pack, M. (2013). Vicarious Traumatisation and resilience: An ecological systems approach to sexual abuse counsellor’s trauma and stress. Sexual abuse in Australia and New Zealand, 5, p. 69-76. Palm, K. M., Polusny,M. A. & Follette, V. M. (2004). Vicarious Traumatization: Potential hazards and interventions for disaster and trauma workers. Prehospital and Disaster Medicine, 19, p. 73-78. Pearlman, L. A. & McKay, L. (2008). Understanding & Addressing Vicarious Trauma. Headington Institute: Pasadena, CA. Schauben, L. J. & Frazier, P. (1995). Vicarious trauma, the effects on female cousenllors of working with sexual violence survivors. Psychology of Women Quarterly, 19, p. 49-64. Trippany, R. L., White Kress, V. E. & Wilcoxon, S. A. (2004). Preventing vicarious trauma: What counsellors should know when working with trauma survivors. Journal of Counselling and Development, 82, p. 31-37. Way, I., VanDeusen, K. M., Applegate, B. & Jandle, D. (2004). Vicarious trauma: A comparison of clinicians who treat survivors of sexual abuse and sexual offenders. Journal of Interpersonal Violence, 19, p. 49-71. 4 27/03/2015 Jessica Perring Educational and Developmental Psychologist jperring@bravehearts.org.au 5
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