Care for Caregivers

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Care for Caregivers

• Presentation
• Peter Essoka
• Trauma Centre Cameroon

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(No Transcript)
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Contamination

• "I love my work but lately I find it
  contaminating my personal life. I have nightmares
  about the horrible things I hear about from
  clients, my sex life has deteriorated, I'm
  irritable and distractible, I'm afraid for my
  kids and tend to overprotect them, and I don't
  trust anybody anymore. I don't know what is
  happening to me."
• A Therapist

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EmpathyDouble-Edged Sword

• Empathetic engagement helps workers meet the
  needs of traumatized peoplehowever, it has
  also been associated with inducting traumatic
  material from the primary victim (the client) to
  the secondary victim (the worker).
• Empathizinghelps the worker to understand the
  clients experience of being traumatized, but in
  the process the worker may be traumatized as
  well. These helpers might develop secondary or
  vicarious traumatization or burnout

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Definitions

• Vicarious or secondary traumatization (VT)
  harmful changes in professionals views of
  themselves, others, and the world as a result of
  exposure to traumatic material
• Secondary traumatic stress (STS) a syndrome
  among professional helpers that mimics PTSD and
  occurs as a result of exposure to the traumatic
  material

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Definitions

• Burnout
• Psychological exhaustion and diminished
  efficiency resulting from overwork or prolonged
  exposure to stress.
• Burnout is a syndrome of emotional exhaustion,
  depersonalisation, and reduced personal
  accomplishment that can occur among individuals
  who work with people in some capacity.

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Common Signs and Symptoms

• Affective e.g., depressed mood, emotional
  exhaustion
• Cognitive e.g., poor concentration, impaired
  memory, intrusions
• Physical e.g., headaches, sleep disturbances,
  cardio-vascular affections, eating disorders
• Behavioural e.g., poor work performance, frequent
  anger outbursts, poor interpersonal
  relationships
• Motivational e.g., loss of interest and idealism
• One core indicator is consistently identified
  exhaustion.

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Common Characteristics

• Cumulative.
• Inevitable.
• Developmental.
• Modifiable.

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PrevalenceHow Big is the Problem?

• 50 of workers suffered from high or very high
  levels of trauma from helping others (Conrad
  Kellar-Geunthar, 2006)
• 37 of child protective workers experienced
  clinical levels of emotional distress associated
  with S.T.S. (Source Meyers Cornille, 2002).

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The Stakes Are High

• If not addressed, secondary trauma may
  adversely affect the caregivers work product and
  interactions with clients. It may also negatively
  impact caregivers emotional well-being and
  relationships with their own families.
• If not recognized and responded to, secondary
  trauma may derail the primary mission of care
  giving organisation--to identify and assist
  torture and trauma survivors.

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Barriers to DetectionReasons Workers May Not
Acknowledge Secondary Trauma

• Self-blame (Its just me!)
• Shame (Im embarrassed to admit it)
• Denial (Itll pass if I ignore it!)
• Self-sacrifice (Dont want to bother co-workers)
• Job Security (I cant expose my weaknesses)
• Pressure (I dont have time to deal with it)
• Cost (I cant afford to take time off spend
  money for help)

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Detection Risk Factors

• Personal Risk Factors
• History of personal trauma
• Personally identify with the victim
• Negative personal circumstances (e.g., grief due
  to recent loss)
• Low levels of social support
• Low levels of resilience (capacity of bouncing
  back)
• Lack of meaningful personal relationships

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Detection Risk Factors

• Work-Related Factors
• inexperience on the job
• high caseload of trauma survivors (e.g., sexual
  violence)
• poor or no supervision
• high frequency of exposure to traumatic material
• exposure to critical incidents

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Detection Risk Factors

• Organisational Factors
• Extraordinary high caseloads
• High administrative burden
• Difficult clients
• Conflicts with co-workers or supervisors
• Climate of pervasive, ongoing change
• Excessive emphasis on efficiency, cost
  effectiveness and competition.
• Unforgiving environment. If you cant handle it,
  get out!.

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• What are your concerns and experience?
• What strategies can you take at
• Individual level?
• Organisational level?

WORKSHOPS
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Intervention and Prevention

• Individual Level
• increase self-awareness
• identify reactions and symptoms
• understand early warning signs
• accurately name and articulate feelings
• construct a fulfilling personal life outside work
  - regenerative relaxing activities, strong
  relationships, etc.
• develop strong support networks (especially
  others who understand trauma work)
• acknowledge and process personal history of
  trauma
• invoke humor
• strive for realistic optimism
• foster opportunities for spiritual growth and
  connection
• recall importance of ones work (i.e., your work
  does make a difference)

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Intervention and Prevention

• Supervisory Level
• educate staff on hazards of secondary trauma
• normalize responses to secondary trauma
• promote ongoing self-assessment
• schedule regular supervision meetings
• utilize a relational, interactive model of
  supervision
• promote other forms of supervision (e.g., peer,
  group meetings).
• identify support resources for workers to access
  if needed
• remind individuals of importance of their work

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Intervention and Prevention

• Organizational Climate
• work-related stress is accepted as real and
  legitimate.
• problem is owned by organization (not merely
  problem workers).
• secondary trauma responses are recognized as
  normal responses.
• focus is on solutions (not blaming).
• support and tolerance clearly expressed to
  worker.
• other climate issues (caseloads, official
  policy, )

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Intervention and Prevention

• Specific Organisational Actions
• in-service training
• policy on secondary trauma
• ongoing program to manage secondary trauma
• regular supervision, consultation and support
  groups
• professional development opportunities
• rotation in caseload and job responsibility
• health care plan with adequate health care
  coverage

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You Make A Difference

• but that difference is only possible when you
  are healthy, functional, and engaged. Caring for
  others is noble caring for yourself is required.
• Author unknown