1. Compassion Fatigue

2. How do you do this work?

3. Learning Objectives The participant will be able to: Understand the concepts of compassion fatigue and vicarious trauma. Recognize the signs and symptoms of compassion fatigue. Appreciate the importance of checking in on oneself and colleagues to assess for compassion fatigue.

4. Compassion Fatigue Compassion Fatigue: a physical, emotional and spiritual fatigue or exhaustion that takes over a person and causes decline in his/her ability to experience joy or to feel and care for others. (Figley, 1995; Friedman, 2002) Also referred to as secondary trauma, vicarious trauma and burnout.

5. Compassion Fatigue Prolonged occurrence of the natural behaviors and emotions that arise from knowing about a traumatizing event experienced by another. a one-way street in which individuals are giving out a great deal of energy and compassion to others over a period of time, yet aren’t able to get enough personal support to reassure themselves that the world is a hopeful place.

6. Compassion Fatigue: Signs & Symptoms Biological Psychological Social

7. Compassion Fatigue: Biological Signs & Symptoms Increased use of drugs and alcohol Sweating, Rapid breathing Increased blood sugar levels Increased illnesses Hypertension/high blood pressure Gastrointestinal complaints  Brittle nails, dull hair, hot flashes

8. Compassion Fatigue: Biological Signs & Symptoms Weight changes: over- or under-eating Migraine headaches Fatigue/chronically tired Cracked teeth/grinding teeth Panic attacks Physical appearance change Sleep Disturbances

9. Compassion Fatigue: Psychological Signs & Symptoms Feelings of dread Anguished “survivor” guilt Feelings of having given up Feelings of evilness and impending doom Anger, less ability to feel joy Increased irritability Horror, inescapable shock

10. Compassion Fatigue: Psychological Signs & Symptoms Decreased concentration/unable to focus Depression, sleep disturbances Low self-esteem, exhaustion Crying for no apparent reason Apathy or use of dark humor Poor impulse control Relapse to addictions

11. Compassion Fatigue: Social Signs & Symptoms Terrorization and elimination Burnout, Chronic lateness Workaholism Inability to maintain balance and objectivity Blaming, Cast out Learned-helplessness

12. Compassion Fatigue: Social Signs & Symptoms Vulnerability Isolation Stuck in negativity, Cynical Divorce/interpersonal problems Lack of trusting people Withdrawal from activities Promiscuity

13. Compassion Fatigue: Prevention Maintain balance between personal life and work Activities, ways to relax, getting enough sleep Strong relationships with family/friends Organizational culture Should allow us to feel comfortable to admit we need help Monitor caseload Working on a team: having colleagues to talk with Education on compassion fatigue helps us recognize the signs early in ourselves and our colleagues

14. Compassion Fatigue: Treatment If you are experiencing the symptoms and you are deprived of sleep, take a day off, rest, and make sure to eat normally. Consider meeting for a few sessions with a therapist who is experienced in treating trauma.

15. References Protecting Children and Young People: The Responsibility of All Doctors. General Medical Council, United Kingdom: 2012. available at: http://www.gmc- uk.org/static/documents/content/Child_protection _-_English_0712.pdf Osofsky, J.D., Putnam, F.W., Lederman, C.S. (2008). How to maintain emotional health when working with trauma. Juvenile and Family Court Journal. 59, 4: 91-102.

16. References A complete list studies that demonstrate the efficacy of Children’s Advocacy Centers is available from the National Children’s Advocacy Center: http://www.nationalcac.org/child-abuse-library- online/evid-based-prac.html