1. Surviving and Thriving During Challenging Times: Self-Care for the Healer Theresa Ford, Ph.D., LPC Keep It Real Conference October 4, 2010

2. Where We are Now Professional helpers today are faced with an increasingly complex set of challenges that include: Clients/consumers who have multiple, complicated, and difficult to address needs Larger caseloads More demands from agencies, such as additional duties, paperwork, procedures

3. Where We are Now (continued) Budgetary cutbacks that affect staffing levels, the availability of resources, and compensation Working for or with systems that have stringent rules, e.g., managed care, and may not be responsive clients’ or helpers’ needs Limited structurally-based opportunities for professional growth and support

4. Where We are Now (continued) Limited external rewards for working under trying circumstances An agency culture that may “pay lip service” but does not truly value self-care and time for renewal Increased activities at home A mistaken belief that the helper doesn’t need help

5. Helpers At-Risk Of necessity, effective professional helpers demonstrate qualities such as empathy, sensitivity, and a genuine sense of caring for those we are charged with helping. However, those qualities, combined with very demanding jobs and constant expose to individuals who are suffering, put helpers at risk for unhealthy levels of stress, compassion fatigue, and burnout.

6. Definitions Stress is the body’s response to demands that can also have psychological, social and behavioral implications. Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress, leaving the individual feeling overwhelmed and unable to meet constant demands.

7. Definitions (continued) Burnout reduces productivity and saps energy, resulting in feelings of helpless, hopeless, cynical, and resentful. Eventually, the helper may feel he or she has nothing more to give. (Smith, Jaffe-Gill, Segal, & Segal, 2008)

8. Understanding Stress and Burnout Stress is characterized by too much, as in too many clients, too many responsibilities, and too much pressure. Burnout is characterized by not enough, as in not enough motivation, not enough caring or connection, not enough hope. (Smith, Jaffe-Gill, Segal, & Segal, 2008)

9. Stress vs. Burnout Stress Characterized by over- involvement Emotions are heightened Produces urgency and hyperactivity Loss of or too much energy Burnout Characterized by disengagement Emotions are blunted Produces helplessness and hopelessness Loss of motivation, ideals, and hope

10. Stress vs. Burnout (continued) Leads to anxiety disorders Much of the damage is physical May cause illness and premature death (Hart, A, Stress and Burnout in Ministry) Leads to detachment and depression Much of the damage is emotional May make life seem not worth living

11. Burnout According to the Texas Medical Association, the major causes of burnout are bureaucratic atmosphere and overwork 3 Stages of Burnout Stress arousal (irritability, anxiety increased blood pressure, etc.) Energy conservation (excessive lateness, procrastination, withdrawal, cynicism, etc) Exhaustion

12. Compassion Fatigue Compassion fatigue, also known as secondary or vicarious trauma, involves a gradual lessening of compassion over time. It can happen to individuals who work closely with persons who have experienced trauma. Professionals with a personal history of trauma, especially if it is unresolved, may be particularly vulnerable.

13. Compassion Fatigue Compassion Fatigue can also be described as the emotional residue of exposure to people in pain, particularly those suffering from traumatic events. Helpers who work with such individuals must contend with the normal stress or dissatisfaction of work, as well as their emotional responses to the suffering of those being helped.

14. Compassion Fatigue

15. Solutions/Coping Strategies Helpful activities to promote wellness: Discussing cases with colleagues Talking with colleagues between sessions Attending workshops Limiting case load Receiving clinical supervision Spending time with family and friends

16. Solutions/Coping Strategies (continued) Travel, vacations, hobbies, and movies Socializing Exercise Developing a spiritual life (Pearlman and MacIan, 1995)

17. Job-Related Skills and Behaviors Prioritize Get Organized Set Boundaries Delegate Where Appropriate Ask for and Accept Help Be Assertive

18. Job-Related Skills and Behaviors (continued) Take Breaks During the Day Negotiate for Better Working Conditions Use Your Leave without Apology Commit to Professional Growth

19. Other Self-Care Suggestions Make Self-Care a Priority Good Nutrition Exercise Rest and Relaxation Address Medical and/or Psychological Issues Adequate Support—At Work and at Home

20. Other Self-Care Suggestions (continued) Set Boundaries Maintain Balance Develop a Positive Attitude Cultivate Compassion for Self Create an Attractive Environment Have Fun Engage in Activities That Feed The Soul

21. Final Thoughts In order to assist the helper in functioning at an optimal level again, 3 things are needed: 1. Honesty with Self 2. Personal Responsibility 3. Self-expression (LaRowe, 2007)