Preparation for UPP students

1
Secondary Traumatic Stress and the Child Welfare
Professional

• Preparation for UPP students
• Adapted from
• Josephine G. Pryce, David H. Pryce, and Kimberly
  K. Shackelford (2007)

2
UPP Seminar

• STS
• Session I
• Session II
• Session III
• Emotional Intelligence
• Goleman
• Journal
• Resource Manual
• Personal and Professional

3
Purpose

• As a child welfare professional, caring for
  others in distress is an integral part of the
  job.
• Caring also carries with it certain costs in
  terms of our mental and physical health and our
  general well-being.
• Learning to cope with the emotional costs of our
  work is the theme of this seminar.
• Purpose The purpose of this seminar is to
  increase your awareness of the emotional costs
  associated with child welfare work and how to
  reduce their effects.

4
Session I Goals and Objectives

• Goals to increase knowledge of secondary
  traumatic stress and its effects on child welfare
  professionals (UPP students)
• Objectives
• To understand concepts related to traumatic
  stress and how it differs from burnout
• To understand the five categories of human
  response to trauma and the consequence of each
• To better understand the unique relationship
  between the child welfare worker and the
  traumatized client

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Primary Posttraumatic Stress (PTS)

• An array of normal human responses following
  direct exposure to one or more traumatic events,
  i.e, natural disasters, acts of extreme violence
  such as combat, life-threatening physical
  assault, or rape.
• May result from trauma experienced as an adult or
  in childhood
• May be immediate or may occur long after the
  event.

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Secondary Traumatic Stress (STS)

• A form of posttraumatic stress that is the result
  of indirect exposure to trauma that arises from a
  relationship with a traumatized client.
• Is a typical human response
• Comes from our perceptions of the clients
  traumatic experience
• Can worsen and become debilitating if ignored or
  unattended
• Sometimes referred to as vicarious traumatization
  or compassion fatigue

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Trauma/Burnout Exercise

• Subject differentiating between traumatic stress
  and burnout
• When I hear the word trauma I automatically
  think
• A burned out child welfare professional is

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Burnout

• Irritability and general distrust of others
  intentions
• No new ideas in the past six months
• Lack of energy physical or emotional
• Feelings of isolation and lack of personal
  support
• Overwhelming urge to leave the work
• Attempts to feel good about oneself by focusing
  on how much one does rather than the quality of
  work completed

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Burnout verses STS

• Burnout
• Is characterized by emotional exhaustion,
  develops gradually, worsens as time passes, is
  associated with high stress and low personal
  reward, is situational and common is some work
  environments
• STS
• Emerges suddenly, either soon or long after
  trauma, is characterized by unpleasant memories
  of an intrusive nature, is characterized by
  feelings of helplessness, confusion, and social
  isolation, is based in the helper-client
  relationship

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Distinguishing between STS and PTS

• Read the index cards
• Distinguish whether the incident is secondary or
  primary trauma

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How do humans respond to trauma?

• Emotional
• Cognitive
• Biological
• Behavioral
• Interpersonal

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Emotional

• Fear and anxiety
• Depression
• Lowered self-esteem or identity problems
• Anger
• Guilt and shame
• Numbing (loss of emotional feelings)

13
Cognitive

• Intrusive mental activity
• Flashbacks
• Nightmares
• Intrusive recollections
• Perceptual disturbances
• Dissociation (altering of consciousness)
• Depersonalization
• Memory loss
• Decrease in attention span
• Decrease in intellectual functioning

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Biological

• Hyper-arousal (hyper-vigilance and
  hyper-atlertness)
• Somatic disturbances
• Sleep disruption

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Behavioral

• Aggressive and antisocial behaviors
• Suicidal behaviors
• Substance abuse
• Impaired social functioning
• Personality changes
• Isolation

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Interpersonal

• Feelings of estrangement from others
• Loss of intimacy
• Sexual problems
• Re-victimization
• Victim becomes victimizer

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Constructivist Self Theory

• Self diagram

Intimacy
Safety
Trust and Dependency
Power and Esteem
Independence
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Intimacy Safety Trust and Dependence
Trauma Independence Power Esteem
Cope Adapt Support
Dump Your Bucket
Birth to 12
12 to 22
Partner Career (CPS) Early Investigation
Guilt and Shame Nightmares Headaches Substance
use Aggression
22 to 25
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Transference Client

• Client System may
• View all authority, including caseworker, with
  distrust
• View situation as one of life or death, and the
  caseworker as omnipotent rescuer
• View caseworker as a person who is contributing
  to the trauma and resist necessary change
• Caseworker must understand that traumatized
  individuals have a distorted worldview and act
  accordingly

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Counter-transference Caseworker

• Trauma can be contagious. Therefore, the
  caseworker may
• Experience the same sort of terror, helplessness,
  and rage as the client (all typical human
  responses)
• Begin to feel distrustful and cynical
• Doubt his or her own ability to assist with
  helping to solve the clients problem
• Set up his or her own psychological defenses to
  counter feelings (i.e. numbing) or have feelings
  of grandiosity or omnipotence (belief that he or
  she has the ability to know all, love all, heal
  all)
• The cruel twist the more empathetic the worker
  is, the more he or she is subject to STS.

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Secondary Traumatic Stress

• Session II

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Session II Goals and Objectives

• Goal
• To increase knowledge of individual coping skills
  that can reduce the effects of STS
• Objective
• To understand personal vulnerability
• To learn to balance the needs of client, agency,
  and self
• To understand the role of supervisor
• To recognize when ones self-care system is not
  working
• To recognize positive and negative coping
  behaviors

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Movie Reign On Me

• Physical
• Social
• Emotional
• Ones personal history of trauma and healing

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Self-Assessment Personal Coping Skills

• Physical
• Sleep, nutrition, exercise
• Social
• Support, getting help, activism
• Emotional
• Life balance, spirituality, relaxation, humor,
  contact with nature, self-expression
• Ones personal history of trauma and healing
• Life book
• Diary

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Self-Assessment Professional Coping Skills

• Workload balance
• Boundaries or limits
• Availability of support
• Professional development
• Job committment

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Supervision

• The supervisor provides a different perspective
• Active supervision
• Listening
• Guiding
• Full range of communication including both
  emotions and cognitions
• Help to access assistance and services
• The supervisor-caseworker relationship is
  reciprocal

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Signs Self-care is NOT working

• Staying numb or in denial for longer than average
  after exposure to a traumatic stressor
• Feeling detached from others
• Seeing others as objects rather than as human
  beings with thoughts and feelings that deserve
  consideration
• Loss of empathy
• Deterioration of personal and professional
  relationships
• Loss of personal and professional effectiveness

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Coping Behaviors

• Positive
• Actively seeking supervision and support
• Supporting colleagues with their own coping
  issues
• Staying physically and mentally fit
• Maintaining a strong social support system
• Negative
• Failing to practice positive coping skills
• Escaping through substance abuse, reckless thrill
  seeking, or risky sexual encounters

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Negative Thinking patterns

• Filtering
• Polarized
• Overgeneralization
• Mind Reading
• Catastrophizing
• Personalization
• Control Fallacies
• Fallacy of Fairness

• Emotional Reasoning
• Fallacy of Change
• Global Labeling
• Blaming
• Shoulds
• Being Right
• Heavens Reward Fallacy

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Thinking

• Filtering You take the negative details and
  magnify them while filtering out all positive
  aspects of the situation.
•  
• Polarized Things are black and white, good or
  bad. You have to be prefect or you are a failure.
  There is no middle ground.
•  
• Overgeneralization You come to a general
  conclusion based on a single incident or piece of
  evidence. If something bad happens once, you
  expect it to happen again and again.
•  
• Mind Reading Without their saying so, you know
  what people are feeling and why they act that
  way. In particular, you are able to divine how
  people are feeling about you.
•  
•  
•  
•  
•  
•  
•  
•  

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Thinking

• Catastrophizing You expect disaster. You notice
  or hear about a problem and start "what ifs"
  "What if tragedy strikes? What if it happens to
  you?"
•  
• Personalization Thinking that everything people
  do or say is some kind of reaction to you. You
  also compare yourself to others, trying to
  determine who's smarter, better looking, etc.
•  
• Control Fallacies If you feel externally
  controlled, you see yourself as helpless, a
  victim of fate. The fallacy of internal control
  has you responsible for the pain and happiness
  around you.
•  
• Fallacy of Fairness You feel resentful because
  you think you know what is best but other people
  will not agree with you.

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Thinking

• Blaming You hold other people responsible for
  your pain, or take the other tack and blame
  yourself for every problem or reversal.
•  
• Shoulds You have a list of ironclad rules about
  how you and other people should act. People who
  break the rules anger you and you feel guilty if
  you violate the rules.
•  
• Emotional Reasoning You believe that what you
  feel must be true automatically. If you feel
  stupid and boring, then you must be stupid and
  boring.
•  
• Fallacy of Change You expect that other people
  will change to suit you if you just pressure or
  cajole them enough. You need to change people
  because your hopes for happiness seem to depend
  entirely on them.
•  
•  

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Thinking

• Global Labeling You generalize one or two
  qualities into a negative global judgment.
•  
• Being Right You are continually on trial to
  prove that your opinions and actions are correct.
  Being wrong is unthinkable and you will go to any
  length to demonstrate your rightness.
•  
• Heaven's Reward Fallacy You expect all your
  sacrifice and self-denial to pay off, as if there
  were someone keeping score. You feel bitter when
  the reward doesn't come.

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Secondary Traumatic Stress

• Session III

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Session III Goals and Objectives

• Goal
• To increase knowledge of social support and how
  it can help to reduce the effects of STS
• Objective
• To better understand what social support is
• To understand how social support can help with
  STS
• To learn how to use social support
• To understand roles of support seeker and support
  provider and how they are important to the social
  support network

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Social Support Systems (Networks)

• Size
• Member roles
• Relationship quality

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Social Support

• Emotion Focused
• Oriented toward feelings
• Problem Focused
• Oriented toward problem solving

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Getting Social Support

• Actively Ask For IT!
• Passively Act Like You Need IT!
• Giving emotion-focused social support
• Support
• Escape

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Giving Emotion-Focused Social Support

• Supporting Behaviors
• Affirming the support seekers ability
• Giving affection
• Providing a time-out
• Giving a gift
• Telling the support seeker everything is okay
• Making sympathetic remarks
• Telling a joke to make him or her laugh
• Laughing with him or her
• Doing something funny

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Giving Emotion-Focused Social Support

• Escape Behaviors
• Talking about what interests you rather than the
  support seeker
• Talking about the helpers task
• Talking about another topic
• Ignoring the support seeker
• Reading a magazine
• Leaving the room
• Telling the support seeker to get over it

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Giving Emotion-Focused Social Support

• Solving Behaviors
• Asking the person whats on his or her mind
• Asking questions about the problem
• Making suggestions
• Dismissive Behaviors
• Making fun of his or her problem
• Telling the support seeker his or her problem is
  not serious
• Laughing when the other person is not
• Talking about your own problems

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Responsibility of Self-Care

• Saakvitne and Pearlman (1996) assert, Self-care
  is an ethical imperative. We have an obligation
  to our clients-as well as to ourselves, our
  colleagues, and our loved ones-not to be damaged
  by the work we do.