Presentation on theme: "DHS Special Treatment Unit"— Presentation transcript:
1DHS Special Treatment Unit BURNOUTMerrill Main, Ph.D.Clinical DirectorDHS Special Treatment Unit
2INTERNAL Have, get, buy, borrow, or rent a life. Lack of self-care. Too much tendency to externalize.Unmanaged general mental health issues.Savior complex gone wrong.Poor affect management.
3EXTERNAL?Answers in Organizational Psychology. For example, Herzberg's Motivation-Hygiene Theory ?
4EXTERNAL Lack of training Unclear expectations Lack of support Lack of resourcesOverutilizationUnderutilization
5NUMBERS 20% to 25% show clinical burnout 30% of the teachers Kadambi and Truscott, 200330% of the teachersRudow, 199950% of medical residentsMartini, S., Arfken, C., Churchill A., and Balon, R. (2004)
6Sexual Offending Is it contagious? Were all sexual offenders once sexual victims?Will all victims become offenders?Do we begin to behave like the population that we work with.
7PARALLEL PROCESSPsychoanalytic idea that relationship between patient and therapist is reflected in relationship between therapist and supervisor.Searles (1955)See the world through the patient’s eyes too often and it may become habitual.
8SYMPTOMS Vicarious Tramatization Hypervigilence Distrust Sexualization Objectification of patientsOver-identification with patientsStressExhaustionDepressionDetachment from workOver-investment in workItalicized are unique to sex offender treatment, second two unique to therapists, latter sx common to all burnout
10YOU’RE THE BESTThe high-school kid striving to be popular is still alive inside all of us.Savior complex.Misguided striving for personal safety.Stockholm Syndrome.
11YOU’RE THE WORST I’ll prove that I’m worthy. The beatings will continue until morale improves.Effort justificationWe like most what we’ve struggled to master
12Divisive Build one faction up, tear another down ‘Shop’ for the best answerPlay one against the otherHighly attuned to existing differences/conflictsMagnify and exacerbate real differencesBetween individualsBetween groupsInstigate conflict for personal pleasure or gain
13Manipulative Starts with small things Progresses to big things Favors given or takenI won’t tellProgresses to big thingsMay seem reasonable at each stepOften starts with small quid-pro-quo
15THERAPIST STYLE“Among the influential therapist behaviors, the most important appear to be: empathy, warmth, rewardingnes, and directiveness.”Marshall (2005)
16Effects and problems of working with sexual offenders Excessive identification with offenders.Excessive anger toward of offenders.Parallel processes.Effect on clinicians’ sexual functioning.Work intruding into life.Become used to talking about sex with patients.
18Burnout Prevention Communicate with colleagues Commiserate with colleaguesUtilize supervisionHAVE A LIFE OUTSIDE OF WORKDon’t worry more about patients’ problems than they do.
19REFERENCESDrapeau, M. (2005) Research on the Processes Involved in Treating Sexual Offenders. Sexual Abuse: A Journal of Research and Treatment. 17,Edmunds, S. (Ed.) Impact: Working with Sexual Abusers. Safer Society: Brandon, Vt.Ennis, L. and Home, S., (2003). Predicting Psychological Distress in Sex Offender Therapists. Sexual Abuse: A Journal of Research and Treatment. 15,Farrenkopf, T. (1992) What Happens to Therapists who work with Sex Offenders? Journal of Offender Rehabilitation. 18(3/4),Kadambi, M., and Truscott, D., (2003) Vicarious Traumatization and Burnout Among Therapists Working with Sex Offenders. Traumatology. 9(4)Lea, S., Auburn, T., and Kibblewhite, K. (1999). Working with Sex Offenders: The Perceptions and Experiences of Professionals and Paraprofessionals. International Journal of Offender Therapy and Comparative Criminology. 43(1),Little, L. and Hamby, S. (2001). Memory of Childhood Sexual Abuse Among Clinicians: Characteristics, Outcomes, and Current Therapy Attitudes. Sexual Abuse: A Journal of Research and Treatment., 13,Moulden, H. and Firestone, P. (2007). Vicarious Traumatization: The Impact on Therapists Who Work With Sexual Offenders. Trauma Violence Abuse. 8,Nelson, M., Herlihy, B., and Oescher, J. (2002) A Survey of Counselor Attitudes Towards Sex Offenders. J of Mental Health Counseling. 24(1),Salter, A. (2003) Staff Seductions. In Predators: Pedophiles, Rapists and Other Sex Offenders. Basic Books:New York.Shelby, R., Stoddart, R., and Taylor, K. (2001) Factors Contributing to Levels of Burnout Among Sex Offender Treatment Providers. Journal of Interpersonal Violence. 16(11),Steed, L., and Bicknell, J. (2001). Trauma and the Therapist: The Experience of Therapists Working with the Perpetrators of Sexual Abuse. Australasian Journal of Disaster and Trauma Studies. 2001(1).Thorpe, G., Righthand, S., and Kubik, E. (2001). Brief Report: Dimensions of Burnout in Professionals Working with Sex Offenders. Sexual Abuse: A Journal of Research and Treatmnet., 13,W.L. Marshall, W. (2005) Therapist Style in Sexual Offender Treatment: Influence on Indices of Change. Sexual Abuse: A Journal of Research and Treatmnet., 17;