Jessica Perring – Trauma for Practitioners

27/03/2015
Bravehearts
Trauma For Practitioners:
Looking After Us
•
Bravehearts’ mission: To stop child sexual assault in our society.
•
Bravehearts’ vision: To make Australia the safest place in the world to
raise a child.
•
Bravehearts’ guiding principles: To, at all times, do all things to serve
our Mission without fear or favour and without compromise and
continually ensure that the best interests and protection of the child are
placed before all other considerations.
Jessica Perring
Educational and Developmental Psychologist
B Psych (Hons). M Psych (Ed and Dev)
Vicarious Trauma Vs Burnout
Vicarious Trauma
• Results from exposure to
others’ traumatic stories
• Results from working with
traumatised individuals
• Refers to negative
changes in inner
experience
• Traumatic reaction; can
experience trauma
symptoms.
Burnout
• Results from work
environment stress such as
work overload, insufficient
rewards.
• Results from working with
any client group
• Refers to emotional
symptoms however doesn’t
result in changes in inner
experience such as
spirituality.
• General psychological
stress.
Symptoms
• Sleep difficulties such as nightmares
• Flashbacks or repeated thoughts or images of traumatic
material
• Changes in beliefs or views – views of trust/safety; beliefs
regarding spirituality.
• Numbness
• Avoidance
• High absenteeism
• Dissociation or zoning out
• Feeling hypervigilant or on edge
• Irritability and anger
• Lack of self-care
Symptoms
• Difficulty managing your emotions
• Difficulty making good decisions and or meeting deadlines
• Problems managing boundaries – taking on too much; trying
to step in and control other’s lives (disempowering clients);
trouble leaving work; difficulty balancing work and home life
• Problems in relationships
• Physical problems – illnesses, accidents, aches and pains
• Difficulty feeling connected to what is going on around you
• Difficulty engaging with clients, reduced empathy
• Loss of meaning and hope
• Feeling helpless or powerless
Assessments
• Compassion Fatigue Self-test – www.myselfcare.org
(Dennis Portnoy, 1996)
• Professional Quality of Life Scale (ProQOL) www.proqol.org (Hudnall Stamm, 2009)
• Are you showing signs of burnout? – www.headingtoninstitute.org
• How Stressed are you? - www.headington-institute.org
• Self care and lifestyle balance inventory www.headington-institute.org
• Trauma and Attachment Belief Scale (TABS)
(Pearlman, 2003)
• Impact of Event Scale – Revised (Weiss & Marmar,
1995)
1
27/03/2015
Prevention of VT
Relaxation
•
•
• Escape – taking time
off, books/films, talking
to friends/family about
things other than work.
• Rest – things that are
relaxing, getting a
massage, sitting down
with a cup of tea.
• Play – activities that
make you laugh, play
with kids, be creative,
physically active.
Progressive Muscle Relaxation:
Muscle tension is associated with stress.
This type of relaxation involves gradually
tensing and relaxing each muscle group:
–
–
–
–
•
Feet & Legs
Stomach
Arms & Hands
Shoulders & Face
Tip: squeeze each muscle for a count of
3.
“The capacity to live by our deepest
values depends on regularly reviewing
our spirit – seeking ways to rest and
rejuvenate and connect with the values
we find most inspiring and meaningful”
(Loehr & Schwartz)
Be Present
Get Active
• “Being Healthy Means
Having An Awareness Of
How To Get The Most Out
Of Your Body Both
Physically And Mentally. It’s
Not A Trend Or A Diet, But A
Lifestyle” - Jason Dundas.
Nourish your Body
• “We are indeed much
more than what we eat;
but what we eat can
nevertheless help us to
be much more than what
we are” Adelle Davis
Social Connection
•
•
•
•
•
Debrief
Supervision
Ask for Help
Ring a friend
Schedule time and
activities with family
and friends
“Friendship makes
prosperity more shining
and lessens adversity
by dividing and sharing
it” Marcus Cicero
2
27/03/2015
Time Out
Pleasant Activities
• Self Care is Not about
Self Indulgence, It’s
About Self-Preservation
– Audrey Lorde
• What makes you
laugh?
• Hobbies
• Camping
• Road trips
• Observing nature
• Gardening
• Board games
• Holidays
• Games
• Family fun
• Only in quiet waters
do things mirror
themselves
undistorted. Only in a
quiet mind is
adequate perception
of the world
Hans Margolius
Photography
Painting
Drawing
Jewellery making
Craft afternoon with kids
Sewing
Gardening
Dancing
Pinterest
Writing in a journal
Collage
Play an instrument
Try a new recipe or decorate a
cake
Work/Life Balance:
• Take a lunch break
• Don’t bring work home
• Create a buffer between
work and home (e.g. music
while driving home)
• Limit the time you spend
with people who tend to
drain your energy
•
“Art washes away from the
soul the dust of everyday life”
Pablo Picasso
Get Outside
•
A 7 year old girl wrote the
following after her teacher
instructed the class to list the 7
wonders of the world: ‘seeing,
hearing, tasting, touching,
running, laughing, loving’
Lists to Live By (Gray, Stephens,
Van Diest)
•
•
•
•
•
•
Benefits of Sunlight:
Helps the quality and length of
our sleep which reduces
fatigue
Boosts vitamin D
Helps immune system
functioning
Strong bones
Increases endorphins (feelgood hormones)
Get a massage
Listen to music
Take a bath
Gardening
Turn off electronics
Balance
Get Creative
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Boundaries:
• Help when you can, but
consciously try not to take
on other people’s problems
• Remember what you can do
in your role, try not to take
on extra responsibilities
Organisational Strategies
•
•
•
•
•
•
•
•
•
•
•
•
•
Take a lunch break
Take annual leave
Debrief
Peer support
supervision
Encourage connection among workers –
team approach, team building activities
with a social component.
Observe your staff/colleagues – check in
and don’t necessarily wait for them to
come to you.
Varied tasks at work
Professional development opportunities
Self-care program
Managers setting a good example and
modelling healthy work habits! ☺
Personally meaningful items on your
desk
Good news stories – share positive
stories in team meetings.
3
27/03/2015
•
•
•
•
•
•
•
•
•
Barriers
Overcoming Barriers
Bravehearts VT prevention Plan
Vicarious Trauma Prevention
Plan
My Risk Factors:
Fortnightly supervision
Organisational culture
Annual Retreat
Monthly counsellor
meetings
Team self-care
Lunch breaks
Professional development
opportunities – research
review; case presentation;
allocated budget
Varied tasks within role
Self-care boxes
•
– List 5 risk factors (Personal – e.g. personal history,
work style, current life circumstance; situation – e.g.
role, work setting; culture – e.g. society attitudes,
beliefs about receiving help)
• My Warning Signs:
– List 5 warning signs (signs and symptoms I have
noticed in myself – e.g. difficulty meeting deadlines;
irritable; tired, nightmares)
• My Strategies:
– List 5 strategies that you will utilise
practice
and
References
•
•
•
•
•
•
•
•
•
•
•
•
•
Bell, H., Kulkarni, S. &Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in
Society: The Journal of Contemporary Human Services, 84, p. 463-470.
Bober, T. &Regehr, C. (2005). Strategies for reducing secondary or vicarious trauma: Do they work? Brief
Treatment and Crisis Intervention, 6, p. 1-9.
Canfield, J. (2005). Secondary traumatization, burnout, and vicarious traumatization: A review of the
literature as it relates to therapists who treat trauma. Smith College Studies in Social Work, 75, p. 81101.
Dombo, E.A & Gray, C. (2013). Engaging spirituality in addressing vicarious trauma in clinical social
workers: A self-care model. Social Work and Christianity, 40, p. 89-104.
Everly, G. S., Boyle, S. H. & Lating, J. M. (1999). The effectiveness of psychological debriefing with
vicarious trauma: A meta-analysis. Stress Medicine, 15, p. 229-233.
McKay, L. (2009). Peace by Piece, Series 1: The basics. Headington Institute: Pasadena, CA.
McKay, L. (2009). Peace by Piece, Series 3: Spirituality. Headington Institute: Pasadena, CA.
Pack, M. (2013). Vicarious Traumatisation and resilience: An ecological systems approach to sexual
abuse counsellor’s trauma and stress. Sexual abuse in Australia and New Zealand, 5, p. 69-76.
Palm, K. M., Polusny,M. A. & Follette, V. M. (2004). Vicarious Traumatization: Potential hazards and
interventions for disaster and trauma workers. Prehospital and Disaster Medicine, 19, p. 73-78.
Pearlman, L. A. & McKay, L. (2008). Understanding & Addressing Vicarious Trauma. Headington
Institute: Pasadena, CA.
Schauben, L. J. & Frazier, P. (1995). Vicarious trauma, the effects on female cousenllors of working with
sexual violence survivors. Psychology of Women Quarterly, 19, p. 49-64.
Trippany, R. L., White Kress, V. E. & Wilcoxon, S. A. (2004). Preventing vicarious trauma: What
counsellors should know when working with trauma survivors. Journal of Counselling and Development,
82, p. 31-37.
Way, I., VanDeusen, K. M., Applegate, B. & Jandle, D. (2004). Vicarious trauma: A comparison of
clinicians who treat survivors of sexual abuse and sexual offenders. Journal of Interpersonal Violence,
19, p. 49-71.
4
27/03/2015
Jessica Perring
Educational and Developmental
Psychologist
jperring@bravehearts.org.au
5