Charles figleys lecture 1 6 17 pdf compassion fatigue

COMPASSION FATIGUE: RECOGNIZING AND MANAGING SECONDARY TRAUMATIC STRESS Charles R. Figley, PhD Kurzweg Chair in Disaster Mental Health, Tulane University Traumatology Institute Director Co-Founder, Disaster Resilience Leadership Academy American Psychosocial Oncology Society Webinar January 10, 2017 from New Orleans, Louisiana, USA

GOAL AND OBJECTIVES

Goal: To build compassion fatigue resilience among oncology professionals Objectives: „ Define Compassion Fatigue and the critical concepts in building resilience „ Address the requirements for caring for those in need including yourself „ Become more attentive to increasing resilience

Psychosocial oncology workers are routinely exposed to patient distress and trauma.

The book is a wake up call to face the risk and recognize the protective factors that determine resilience to compassion fatigue.

FIRST DO NO SELF HARM

COMPASSION FATIGUE STRUCK A CORD „The concept

conveyed the challenges of dispensing compassion, empathy, love, and support

COMPASSION FATIGUE RESILIENCE MODEL

THE COMPASSION FATIGUE (CF) RESILIENCE MODEL Focus is on quantifying resilience Though the Model focuses on the individual, it takes

into account systemic and community implications by calculating individual vulnerability to the distress experienced by human service providers May lead to poor performance and the overall resilience of the community served by the providers.

Wise investment of time and and program focused on prevention.

CF RESILIENCE MODEL Represents the current understanding of the

primary risk factors and protective factors predicting compassion fatigue and resilience to it.

Is a roadmap for helping those helping the traumatized, Is an update to my 1995 model and since 2016.

Is a reflection of interviews and reviews of the literature.

DEFINITIONS

WHAT IS COMPASSION FATIGUE? Caregiver's reduced capacity or interest in

being empathic or “bearing the suffering” and is “the natural consequent behaviors and emotions resulting from knowing about a traumatizing event experienced or suffered by another person or people.”

OTHER USEFUL DEFINITIONS:

SECONDARY TRAUMATIC STRESS (STS) The internal pressure to help the suffering

(i.e., family member, client, fellow team member) In contrast to primary traumatic stress (being in harm’s way) those who attend to the needs of those in harm’s way experience secondary traumatic stress (STS).

COMPASSION FATIGUE RESILIENCE is the spectrum of resources available to the human

service worker varying from very low resilience to very high resilience.

High resilience would include the optimization and self-nurturance through Self-Care, Detachment, Sense of Satisfaction and Social Support, which are considered the resilience or “protective” factors.

This form of resilience offers adaptation and coping as well as resistance to secondary traumatic stress.

COMPASSION FATIGUE RESILIENCE As a result, the trauma-exposed person can

develop into a confident, caring, competent and efficient worker and social being.

Compassion fatigue resilience is reached when one’s compassion core (empathy for client, self, and colleagues) is honed and built (Harrison & Westwood, 2009).

COMPASSION FATIGUE RESILIENCE MODEL

APPLICATION

APPLICATION OF THE MODEL a practitioner with high compassion fatigue

resilience has the ability to withstand considerable distress of others; whereas the practitioner with low compassion fatigue resilience experiences symptoms of distress and distraction associated with compassion fatigue and has difficulty witnessing another’s suffering

COMPASSION REQUIREMENT dedication to the sensitivity to the pain and suffering of others often springs from deeply held values and a commitment to the highest standards of professional and ethical practice.

To be compassionate is to be effective in assessing and helping the suffering.

EMPATHIC RESPONSE – KEY TO EFFECTIVE HUMAN SERVICES Empathic Response effective in human services work, requires: Exposure to the suffering Empathic Ability Empathic Concern for the suffering

THE DEVELOPMENT OF SECONDARY TRAUMATIC STRESS Self-care and selfcare plan Detachment from distress Sense of Satisfaction as a caregiver Sense of Satisfaction with being a caregiver

Other Life Demands

Secondary Traumatic Stress is the canary in the coal mine = predicts risk and resilience to CF

Compassion Fatigue Resilience Level Traumatic memories that distract from doing your job

REACTIONS

Secondary Traumatic Stress Reactions Client(s) evoke anxiety Thinks of some client’s experiences involuntarily Emotional Numbing

Little interest in being around others Avoids client-related people, places, or things Less active than usual Client triggers Discouraged about distress the future Avoided working Expect something with some clients bad to happen Trouble concentrating

Client session memory gaps Unintentional thoughts about client(s) Easily annoyed Client-related disturbing dreams Stress-related sleeplessness Felt jumpy

ATTENTION TO INCREASING COMPASSION FATIGUE RESILIENCE: DEVELOP A SELF-CARE PLAN

STEP 1. ASSESSMENT A. Collect self-assessment data B. Complete Score Pattern Analysis C. Compare the results with your self-

perceptions, and the perceptions of family, friends and colleagues.

ASSESS PROTECTIVE FACTORS, e.g., Self-Care

Self-Compassion (Neff)

Social

Support

Purdue Social Support Scale (Figley)

ASSESS RISK FACTORS, e.g., Other Life Demands Social Readjustment Rating Scale (Holmes Rahe)

Secondary Traumatic Stress Secondary Traumatic Stress Scale (Bride)

COMPLETE SCORE PATTERN ANALYSIS Risk Factors

Score High

Mod

Low

Other Life Demands -Social Readjustment Rating Scale (Holmes Rahe) Secondary Traumatic Stress -Secondary Traumatic Stress Scale (Bride)

Score Protective Factors Self-Care -Self-Compassion (Neff) Social Support -Purdue Social Support Scale (Figley)

Low

Mod

Hig h

STEP 2. DEVELOP GOALS Based on data, identify three (3) SMART* goals.

Goals may be Maintenance (continue doing

what works) and/or growth (add that which will increase resilience).

*Specific~Measurable~Attainable~Realistic~Time-Based

COUNTERBALANCE SYMPTOMS/REACTIONS WITH HEALTHY COPING Symptoms/Reactions Physical

Mental

Emotional

Healthy Coping Strategies

SELECT STRATEGIES FOR INDUCING RELAXATION RESPONSE Strategies Breath Work

Meditation

Progressive Relaxation

Anxiety

X

X

X

Visualization/ Guided Imagery X

Chronic pain

X

X

X

X

Depression Fatigue Headaches/ Migraine Headaches High Blood Pressure

X X

X

X X

X

X

X

X

X

X

Insomnia

X

Irritability

X

Muscle Tension

X

Stress Reaction

X

X X

X

X

X

X

STEP 3. ACCOUNTABILITY Identify two (2) accountability buddies with whom you will meet to monitor your goals, and set a time/place to meet. „one buddy should be identified from your work

place, and „the second should be identified from your personal life.

STEP 4. RE-EVALUATE DATA PERIODICALLY Take assessments and meet with accountability

buddy when Going

to work is difficult Work productivity begins to suffer Patient satisfaction decreases Symptoms/reactions increase

SEEK PROFESSIONAL HELP WHEN…

CONCLUSION

CONCLUSIONS Thus, have compassion for the

compassionate.

The compassionate benefit as much as the recipient of compassionate care.

Compassion is a learned behavior benefits the receiver of compassion but also the compassion provider.

CONCLUSION (CONTINUED) Protective and risk factors may be assessed

to determine overall level of compassion fatigue resilience Using data from the assessments, a growth or maintenance plan may be developed An accountability buddy will provide ongoing support in meeting goals

CONCLUSION (CONT.) What is the quality of care they are

delivering to the traumatized?

Q&A?

CONTACT: CHARLES FIGLEY

CharlesFigley.Com Email:

Figley@Tulane.Edu Phone: 504-862-3473