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Empathy Fatigue: Dealing Effectively with the Stress and Grief Reactions of Extraordinary Stressful and Traumatic Events Mark A. Stebnicki, Ph.D., LPC,

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Presentation on theme: "Empathy Fatigue: Dealing Effectively with the Stress and Grief Reactions of Extraordinary Stressful and Traumatic Events Mark A. Stebnicki, Ph.D., LPC,"— Presentation transcript:

1 Empathy Fatigue: Dealing Effectively with the Stress and Grief Reactions of Extraordinary Stressful and Traumatic Events Mark A. Stebnicki, Ph.D., LPC, CRC, CCM Professor, Dept. of Rehab Studies East Carolina University

2 Empathy Fatigue: Healing the Mind, Body, and Spirit of Professional Counselors (Springer Publishing -2008) ~~~~~~~~~~~~~~~~~~~~~~~~ Personal Testimonials of Persons’ Experience of Empathy Fatigue

3 Purpose and Intent  Identify & Recognize Critical Pathways to Empathy Fatigue (EF) and other professional fatigue syndromes.  Describe Cumulative effects and Impact on the professional counselor which leads to the deterioration of the counselor’s empathic engagement with their clients.  Provide Self-care Strategies for pre- professionals, counselor educators and supervisors that cultivate healthy coping and resiliency.

4 A Consciousness Shift in the Counseling and Allied Helping Professions  September 11, 2001 (2,996 deaths)  War in Afghanistan & Iraq (4,493 U.S. Soldiers; 88,456 Iraqi Civilian deaths +)  Tsunami December 26 th 2004 (275,000 deaths in 11 countries  Hurricane Katrina 2005 (70 deaths +)  Child Deaths by intentional-unintentional gun violence (3,024yr)  School deaths due to violence ( ; )  Cumulative AIDS-related deaths in U.S (through ,669d); Ethiopia (1.8 mil predicted by ’08)

5 Healthy Occupational Outlook for Counselors  Fire  Flood  Hurricanes/Tornados  Ice storms  Plane crashes  Volcanoes  Earthquakes  Epidemics  Workplace violence  Traumatic injury in the workplace  School shootings  Bioterrorism  Transportation Accidents  Civil Unrest  2 nd Depression

6 A Constant State of Disaster Preparedness: Crisis Response Teams  ARC/State Disaster MH  EMS/IC-EM  Law/Fire  Public Health  DSS  School Counselors  CISM Teams  MH/LME  EAPs  Baptist Men  Salvation Army  United Way  FEMA  National Guard/Military  Insurance Adjustors  Media  Airline Industry  Banks/Financial Institutions

7 Empathy Fatigue (EF) “ A dynamic state of psychological, emotional, social, physical, occupational, and spiritual exhaustion that occurs on a continuum, resulting from the helpers’ own wounds that are continually revisited by their client’s life-stories of stress, chronic illness, mental/physical disability, trauma, grief, and loss.”

8 EF-The Wounded Healer Experience  Traditional Native American teachings “each time you heal someone you give away a piece of yourself until at some point you require healing.”  The wounded healer phenomenon has been noted throughout the history of counseling, psychology, and through spiritual leaders (Jung Nouwen, Rogers, Dali Lama)  Journey to become a counselor, healer, or Shaman comes with the understanding that there is a cost to M-B-S.

9 EF- Both Same and Different as Other Counselor Impairments Countertransference (Ones’ Emotional Scrapbook): (Freud) unconscious absorption of the client’s issues (Modern) symbolic experience of emotional self button-pushing; Burnout : - Classical (Freudenberger, 1974): a state of physical, emotional, and mental exhaustion; a negative shift in the way professionals view people they serve. - Contemporary (Maslach, [MBI]1982; 2003): 3 Factors- cumulative emotional exhaustion (EE), depersonalizaiton (DP), feelings of a lack or reduced personal accomplishment (PA) Consequences: a loss of compassion, genuineness, and concern for the client/consumer.

10 Comparing and Contrasting EF CCCCompassion Fatigue (CF): - Nursing Profession (Joinson, 1992): a special type of burnout experienced by those working in high stress or high touch professions (trauma, loss of life). - Evolving Construct (Figley 1995; 2002; Stamm, et al.) An acute stress reaction or unhealthy form of countertransference results from a state of emotional, mental, and physical exhaustion. CF is both same and different BUT CF is acute-BO is not. - Secondary Traumatic Stress (STS) Same as PTSD!

11 Professional Fatigue Syndromes: A Concern for the Helping Professions  APA - Advisory Committee on Colleague Assistance Impaired Professionals.  AMA- Physician Impairment: “physical, mental, and behavioral disorder that hinders the physician’s ability to safely treat patients safely.”  American Nurses Association- “Compassion Fatigue”.  ACA Task Force on Counselor Wellness and Impairment: -Educate counselors on prevention strategies -ID resources counselors -Intervention and treatment recommendations -Advocate for professional counseling associations to establish programs on counselor impairment

12 Ethical Considerations in EF  “ Counselors are alert to the signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when such impairment is likely to harm a client or others” (ACA; p. 9 Section C.2.g)  “Counselors shall seek assistance for problems that reach the level of professional impairment, and if necessary, they limit, suspend, or terminate their professional responsibilities until such time it is determined they may be safe to resume their work” (ACA; p. 9 Section C.2.g)

13 Epidemiology of Empathy Fatigue: How is EF Experienced?  Empathy and compassion is the foundation of counselor pre-professional training (Rogers; Corey & Corey; Ivey & Ivey)  Intense interactions requires intense listening and results in intense parallel experiences.  Many counselors spend a tremendous amount of energy trying to understand the meaning of their client’s exp.  There’s a cost for counselors searching through their client’s emotional scrapbook looking for all the losses, grief, pain, and suffering.

14 Theoretical EF: Critical Pathways  Counselors who use empathy-focus therapeutic interactions may be more at risk for EF.  EF is an unconscious process where the professional and those around them may not recognize counselor fatigue. EF can occur early-on developmentally in supervisees due to pre-existing personality traits, general coping resources, age, counselor-developmental factors, opportunities in clinical experiences to build resiliency, organizational, and environmental supports.EF can occur early-on developmentally in supervisees due to pre-existing personality traits, general coping resources, age, counselor-developmental factors, opportunities in clinical experiences to build resiliency, organizational, and environmental supports.  EF is cumulative and ranges on a continuum of low, moderate, and high levels of physical-emotional-mental spiritual, and occupational exhaustion. Can be both acute and cumulative.

15 Theoretical Empathy Fatigue  EF (is much like stress) can be experienced by the pre- professional & professional as both an acute, chronic, delayed onset reaction ranges on a continuum.  EF experienced by person dealing with a variety of issues- client’s daily hassles, stress, grief, loss, addictions, or trauma.  Cumulative effects of EF leads to higher levels of the deterioration in the pre-professional counselor’s coping abilities and resiliency.

16 Consequences of Empathy Fatigue? - Depletion of the counselor’s interpersonal effectiveness - Reduced warmth, compassion, intuitiveness - Physiological type of chronic fatigue - Social and Peer-professional withdrawal - Lack of mental focus - Decreased meaning in one’s career - Existential confusion - Loss of connection with spiritual or religious practices - Parallel experience with client living life out of balance

17 Philosophy of EF It is not necessarily the nature of the client’s stress, trauma, loss, grief, daily hassles, unhealthy coping, or disability adjustment issues that creates a sense of EF; rather, it is the counselor’s perception towards that particular client the counselor’s attributes that determines the professional’s response to it; As a consequence, leads to a diminished capacity to listen, respond empathically, and provide competent professional services…overall effects on M-B-S.

18 What Are EF Risk Factors?  Personality Traits  History of MH Problems  Maladaptive Coping Behaviors  Age and Experience-Related Factors  Organizational Factors  Job Duties within the Organization  Socio-Cultural Factors  Person’s Response to Past Events  Level of Support

19 Global Assessment of EF Rating Scale: A Theoretical Measure  Theoretical scale: ranging from Level 5(H-EF) – Level 1(L-EF).  Constellation of States, Traits, Behavioral Dimensions: Cognitive; Behavioral; Spiritual; Process Skills; Emotional; Physical; Occupation.  Suggested use: Self-ratings; Ratings by clients; Independent peer-observer; Independent researcher.

20 What are Counselors’ Experience of EF?  Think back to the earliest memory in your career as a professional counselor. What did you experience (physically, emotionally, cognitively, spiritually, existentially, and occupationally)- early-on; after a difficult client session- or difficult day in your particular setting?

21 Counselors’ Experience of EF  Please discuss some of your more recent client sessions (within the last month). What did you experience (physically, emotionally, cognitively, spiritually, existentially, and occupationally); after a difficult client session- or difficult day in your particular job setting?

22 Exploring Counselor’s Coping & Resiliency  After all you have experience (personally and professionally) working as a professional counselor – what are some things that you could share with new professional just entering the helping profession (in terms of day-to-day issues or some of the more very difficult client issues)?  Please discuss any specific coping or resiliency strategies you have developed over your career.

23 EF Assessment for Counselor Supervisors: Share Your Experiences 1.I chose the field/occupation of counseling because… 2.I work best with clients who are… 3.I feel good and am encouraged by my client’s success when they… 4.I am most negatively affected by my clients who… 5.My needs are met when they… 6.I generally do not work well under conditions that involve… 7.If I could make any change(s) in my situation I would…

24 Ethical Review Checklist for Counselor Supervisors Does the Supervisee: 1.Have the necessary and sufficient skills and competencies to provide services to clients/consumers at least provisionally? 2.Possess training that has reached an acceptable level of competency in the specialty area that they practice? 3.Have the ability to control or cope with the personal, emotional, psychological stress of their job? 4.Possess enough self-awareness to limit or suspend their practice when they are at risk for EF?

25 Resilient Professionals  Convey a sense of genuine commitment and confidence to help with their client’s stress levels and critical issues- despite dealing with one’s own level of life difficulties;  Communicate competence and have a good sense of mastery with handling challenging and difficult clients- without depletion of one’s own mind, body, and spirit;  Feel optimistic, positive, and energetic about the good work they do and have good coping resources- even in tough times;  Have a purpose-driven life, find meaning in their profession and practice good self-care techniques;  Maintain excellent interpersonal insight and still have the capacity for warmth, caring, and empathy.

26 The Resiliency Advantage Dr. Al Siebert 1. Making conscious choices in life. 2. Power of Positive Thinking. 3. Take responsibility. 4. Internal locus of control. 5. Self motivate yourself. 6. Don’t fear trying-out new things. 7. Take control of your life. 8. Practice positive approaches to life.

27 Adaptive Coping & Healing Strategies: Organizational Skilled & Competent clinical supervisionSkilled & Competent clinical supervision Mentoring approachesMentoring approaches Peer-supervisionPeer-supervision Shift focus of treatment team meetingsShift focus of treatment team meetings Re-structure organizational philosophy to a healthy person-centered {M-B-S}Re-structure organizational philosophy to a healthy person-centered {M-B-S}

28 Show-up Pay Attention Be Open to the Outcomes

29 Wellness Approaches BreathingMeditationVisualization


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