When Helping Hurts: Compassion Fatigue Prevention Workshop for Practitioners by Kathy Regan Figley a

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When Helping Hurts Compassion Fatigue Prevention
Workshop for PractitionersbyKathy Regan
Figleyand Charles Figley

• Sponsored by the New Mexico Department of Health
• Behavioral Health Services Division
• at the Sheraton Old Town Hotel, Albuquerque

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Overview

• Goal and Format
• Objectives
• Agenda

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Part I Introduction

• Who are we?
• Worked how long and with whom?
• Survivor strategies?

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When Helping Hurts

• Brief (15 minute) Version of a video on sale here
  at the conference, produced by Gift From Within.
• Think about your own work and its impact on you.

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Part II Developing Compassion Fatigue (CF)

• Objective Identify the factors which contribute
  to the development of CF

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COMPASSION FATIGUE

• A state of tension and preoccupation with
  traumatized individual(s) by
• re-experiencing the traumatic events,
• avoidance/numbing of reminders, and
• persistent arousal (e.g., anxiety)

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Compassion Fatigue Process
Score Interpretation
Critical Life Events
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COMPASSION FATIGUE

• Seven characteristics, compared to
• Burnout and Countertransference

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Activity Measuring Life Stress

• Instructions
• Circle the number of any event which has occurred
  in your life over the past 12 months.
• Add up the numbers for your total score.

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Score Interpretation

• Score 150-199 37 chance of a minor illness in
  the next two years.
• Score 200-299 51 chance of developing a major
  illness in the next two years. 
• Score over 300 79 chance of a major health
  breakdown in the next two years.

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Part III Detecting Compassion Fatigue

• Objectives Identify the symptoms of compassion
  fatigue (CF) and determine how much at risk we
  are of having CF and burnout
• Break alert
• Please Complete the Self Test prior to
  re-convening

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Lets take a Break!

• 15 minutes and counting

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Discussion of Self-Test Results

• What is your level of
• compassion satisfaction?
• compassion fatigue?
• burnout?
• Lets discuss the answers to the questions about
  your scores

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Body Scan

• Focus on areas in your body that ache, hurt, feel
  uncomfortable.
• Make notation on picture where those places are

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What do your scores possibly mean?

• Low Burnout, Low Compassion Fatigue, High
  Satisfaction
• Ø Enjoy Your Job!
•  
• High Burnout, High Compassion Fatigue, Low
  Satisfaction
•  Change Careers
• High Burnout, Low Compassion Fatigue, High
  Satisfaction
•  Change Jobs

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What do your scores possibly mean?

•  
• Low Burnout, High Compassion Fatigue, High
  Satisfaction
• Stay and Manage the Emotional Toll of the Work
•  
• Low Burnout, Low Compassion Fatigue, Low
  Satisfaction
•  Change Population Served

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Compassion Stress and Fatigue

• the natural consequent behaviors and emotions
  resulting from knowing about a traumatizing event
  experienced by a significant other

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• The compassion trap is the inability to let go of
  the thoughts, feelings and emotions useful in
  helping another, long after they are useful.

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Cumulative Work Demands

• Work-related problems leading to compassion
  fatigue are common and may result in either an
  intervention or disciplinary interview.

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Cumulative Stress Symptoms

• Physical
• Behavioral
• Interpersonal
• Cognitive
• Emotional
• Spiritual
• Job performance
• Morale

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Work-Related PTSD

• A. The person has been exposed to a traumatic
  event in which both of the following have been
  present
• (1) the person has experienced, witnessed, or
  been confronted with an event or events that
  involve actual or threatened death or serious
  injury, or a threat to the physical integrity of
  self or others (italics added)
• (2) the person's response involved intense fear,
  helplessness, or horror

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Assessing Your Demands now and remembered

• Work Related and Life Situations Which
• Trigger Stress Response
• Instructions
• List twenty situations in your life - work and
  personal, which trigger a stress response in you.
  (Examples are working extra shifts, preparing
  paperwork, argument with spouse, child's problems
  in school, dental work).
• After all items are listed, rate each with a SUDS
  level,
• rank the items based on SUDS level.
• Are we distressed yet??????

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Part IV Preventing and Recovering from
Compassion Fatigue

• Objective Describe stress resiliency, self care
  strategies in self and others

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CF Prevention Affecting Institutional Policies
And Procedures

• Awareness of risks and costs on troopers and
  their families
• Commitment to lower the risks and costs
• Adequate applicant screening for resilience and
  awareness
• Adequate policies and procedures to educate and
  protect workers
• Work group attitudes and plans

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Combating CF Individual Actions

•  Strategies for letting go of work (detachment)
• Strategies for gaining a sense of achievement
  (satisfaction)
• Strategies for acquiring adequate rest and
  relaxation
• AND The perfect stress reduction method see the
  following

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Breath Work

• Relaxing Sigh
• Complete Natural Breathing
• Purifying Breath
• Tap Away Tension
• The Bracer
• The Windmill
• Bending

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Safe Place

• Visualize a place where you feel secure and
  joyful
• Allow a private entry into your place
• Focus on the comfort, safety and peacefulness of
  your place
• Fill it with as much detail as you can what you
  see, hear and smell
• Allow room for someone you feel safe with to
  share it with you

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Progressive Relaxation

• Curl both fists, tightening biceps and forearms
  (Charles Atlas position)
• Wrinkle up forehead
• Wrinkle up face
• Arch back and take deep breath
• Pull feet and toes back toward face, tightening
  shins
• Curl toes and tighten calves, thighs and buttocks

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Meditation

• Establish posture
• Center Yourself
• Close eyes or fix on spot on floor
• Focus attention on each breath
• Count each exhale breath in cycles of four
• If mind wanders thats OK, simply turn focus back
  to breathing
• The sounds of the outside world will enter your
  attention simply let them pass

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Visualization/Guided Imagery

• Close eyes gently
• Scan your body for tension, and relax those
  muscles as best you can
• Form mental sense impressions Involve all
  senses sight, smell, hearing, touch and taste
• Use affirmations (short positive statements that
  help you relax)
• For guided imagery record a tape in a soothing
  calm voice and listen (NOT while driving)

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Autogenics

• Select comfortable autogenic posture
• Repeat verbal formulas slowly then pause
• My right arm is heavy
• My left arms is heavy
• Both arms are heavy
• Above plus
• My right leg is heavy
• My left leg is heavy
• Both of my legs are heavy
• My arms and legs are heavy
• (can include warm with heavy)

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Refuting Irrational Ideas

• Write down the facts
• Write down your self-talk
• Focus on your emotional response
• Dispute and change the irrational self-talk
• Select the irrational idea
• Is there any rational support for the idea
• What evidence exists for the falseness of the
  idea?
• Does any evidence exist for the truth of this
  idea?
• What is the worst thing that could happen to me?
• What good things might occur?
• Substitute alternative self-talk (Affirmations)

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Coping Skills (coping statements)

• Prepare
• Confront the Stress Situation
• Cope with the Fear
• Reinforce Success!

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Other Stress Reduction Methods (e.g. EFT)

• Emotional Freedom Technique

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Visualization (with music)

• Select a safe place
• Listen to your breathing
• Let you mind wander to someone in the past you've
  really helped
• Let your mind wander to a supervisor/co-worker
  who really thinks you're great

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• Let your mind wander to safe place to think about
  these questions
• What do I want out of my life and career from now
  on?
• How can I remind myself to take care of myself
  more to reach those goals?

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Other Methods

• Journaling
• Art Therapy
• Poetry Therapy
• Music and Other Creative Therapies
• Dance and Other Kinesthetic Treatments

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Compassion Fatigue Desensitization

• Cognitive Behavioral Therapy
• Eye Movement Desensitization and Reprocessing
  (EMDR)
• Video Dialogue and Other Gestalt Methods

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Part V Conclusion -- Matching Techniques to
Symptoms

• Look at the list of techniques and list the
  reasons you like, hate or might use each one.
• Think about the symptoms you have identified.
• Which of the techniques you like will work for
  these symptoms?

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Excellent Resources

• Books
• Websites

David Baldwin's Trauma Information Pages
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Adjourn
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Contacting the Instructors

• Charles Figley School of Social Work, Florida
  State University [phone]
• Cfigley_at_mailer.fsu.edu
• Kathleen Regan Figley, MS, MT
• Green Cross Foundation, Inc.
• Tallahassee, Florida
• E-Mail GCFRegan_at_aol.com
• Website www.greencross.org