How social workers can prevent compassion fatigue

Estimated read time: 1:20

Summary

This informative session, led by Charlene Richard from the Canadian Association of Social Workers, offers valuable insights into compassion fatigue, especially for social workers. The webinar discusses the differences between compassion fatigue, burnout, and vicarious trauma, and provides strategies to prevent and manage these challenges. Charlene shares personal experiences to illustrate the phases of compassion fatigue and emphasizes the importance of personal awareness, emotional regulation, and professional support in sustaining a healthy career. Participants are encouraged to practice sustainable caring to maintain their well-being while helping others.

Highlights

Charlene Richard discusses the sneaky nature of compassion fatigue and its impact. 🔍
She introduces the concept of sustainable caring to mitigate burnout. 🌱
Participants learn to identify phases of compassion fatigue to manage them effectively. 📊
Emotional contagion can be controlled through regulation and awareness. 🔄
Charlene emphasizes the power of empathy and the need for protective strategies. 🛡️

Key Takeaways

Compassion fatigue is common in helping professions, but manageable with the right strategies. 😊
Understanding the difference between burnout and vicarious trauma is crucial. 🔍
Emotional regulation and self-awareness are key to maintaining mental health. 🧘‍♀️
Empathy is a powerful tool, but must be managed consciously. 🛠️
Sustainable caring allows for effective and compassionate professional life. 🌿

Overview

Charlene Richard, a clinical social worker, tackles the pervasive issue of compassion fatigue among social workers, using both empirical data and her firsthand experiences. She highlights how it begins subtly, often unnoticed, before escalating. 🌟 Her personal journey underscores the professional hazards faced in environments laden with trauma.

Participants learn to discern the phases of compassion fatigue and ways to counteract its effects. Richard emphasizes that while empathy is central to the profession, it can also lead to emotional overloads if not managed with intention. Emotional regulation and self-awareness are essential components to maintaining one's well-being. 🌈

Richard introduces the practice of sustainable caring, which focuses on balancing empathy with self-care to prevent burnout. She discusses organizational roles and personal responsibility in mitigating compassion fatigue, advocating for systemic changes alongside personal strategies. 🌿 Her practical advice is aimed at helping social workers sustain passion and efficacy in their roles.

Chapters

00:00 - 01:00: Introduction The chapter introduces Sally Guy, the director of policy at the Canadian Association of Social Workers, who will be moderating the event. It highlights the use of audience feedback via a survey widget and mentions the prevalent concern of compassion fatigue among social workers in Canada.
01:00 - 04:00: Speaker Introduction and Professional Background The chapter begins with logistical information about accessing a recording of the presentation, downloading the slide deck, and obtaining a certificate of attendance. These instructions are available in the Welcome widget that appears upon logging in. Additionally, users are informed they can resize and move the widgets on their screen for better visibility of slides and resources.
04:00 - 32:00: Compassion Fatigue Concepts and Strategies The chapter introduces the speaker, Charlene Richard, a registered clinical social worker from Calgary, Alberta. Charlene specializes in addictions, mental health, and compassion fatigue. She has developed a program called 'Caring Safely' which focuses on teaching strategies related to compassion fatigue. The chapter sets the stage for a session that includes a Q&A period and access to further resources and tools provided by the speaker.
32:00 - 37:00: Audience Polls on Experience and Training The chapter discusses the topic of preventing compassion fatigue among service providers and organizations. Charlene, an experienced educator on this issue since 2008, has been helping community, provincial, and federal organizations address this concern. In 2015, she authored a book titled '20 Click Strategies to Help Your Patients and Clients Manage Stress', which contains a chapter on clinician wellness. The chapter also introduces a workshop aimed at aiding social workers across Canada in managing compassion fatigue, demonstrating Charlene's valuable contributions to this field.
37:00 - 40:00: Compassion Satisfaction and Job Impact The chapter, titled 'Compassion Satisfaction and Job Impact,' begins with a welcome and introduction to a webinar focused on preventing compassion fatigue among social workers. The speaker expresses their enthusiasm for discussing this topic, particularly with social workers, whom they regard as a great group of individuals to engage with on such a subject.
40:00 - 58:00: The Reality of Compassion Fatigue The chapter introduces the speaker, a clinical social worker and behavioral health consultant in Calgary, Alberta. The speaker emphasizes the relevance of understanding the background and ideology of someone who provides information, as it can be influenced by their research and experience. The focus is on primary care mental health and the professional's role in this field.
58:00 - 78:00: Vicarious Trauma and Strategies to Manage It The chapter titled "Vicarious Trauma and Strategies to Manage It" involves a professional's experience working with adults dealing with addiction and mental health issues since 2005. The professional has specialized in grief, trauma, and compassion fatigue. They apply various therapeutic frameworks including solution-focused, cognitive behavioral therapy, dialectical behavioral therapy, acceptance and commitment therapy, and mindfulness-based interventions, as well as yoga.
78:00 - 89:00: Phases of Compassion Fatigue This chapter introduces the subject of compassion fatigue, focusing on the trajectory and phases it involves. The instructor, also the founder of an online program called Care and Safety, outlines the structure of the lesson to include discussions about compassion fatigue, vicarious trauma, and burnout, while specifically emphasizing the phases of compassion fatigue.
89:00 - 101:00: Burnout and Personal Protective Factors This chapter explores the onset of compassion fatigue, emphasizing its often unnoticed and subtle beginnings. The chapter outlines the signs and risk factors associated with compassion fatigue. Additionally, it introduces three strategies aimed at self-protection against this condition. The concept of 'caring safely' is introduced, offering insights into ensuring long-term, sustainable caregiving.
101:00 - 121:00: Strategies for Sustainable Caring The chapter titled 'Strategies for Sustainable Caring' features a segment where the audience is engaged with a poll about their experience in Social Work. Participants are categorized based on their duration in the field, including students, those with less than two years, three to five years, five to ten years, and those with over ten years of experience.
121:00 - 148:00: Audience Questions and Discussion The chapter titled 'Audience Questions and Discussion' involves reviewing and analyzing the composition of the audience. It notes that there are no students present. The audience's experience levels vary, with around 7-8% having less than two years of experience, 83% having between two to five years, and 15% having five to ten years of experience. Additionally, it highlights that a significant portion, 54%, has over ten years of experience.

How social workers can prevent compassion fatigue Transcription

00:00 - 00:30 good evening everyone and thanks for attending my name is Sally guy and the director of policy here at the Canadian Association of Social Workers and I will be moderating today as you've probably noticed if you've attended any of our events before we do collect feedback from the audience through our survey widget during each of the webinars so we've heard from social workers across Canada that compassion fatigue is a major concern for so many so I'm not surprised that we have so many social workers tuning in tonight before I
00:30 - 01:00 introduce our speaker I just want to note that all the details you need like how to access the recording of the presentation later how to download the slide deck how to get your certificate of attendance all that information is written down in the Welcome widget that popped up when you logged on and also we get this question a lot you can resize any of those widgets or those boxes on your screen you can drag them around and maximize and minimize so it's easier to see the slides or so you can check out the resources at the same time as you're
01:00 - 01:30 listening so as for the format we will have lots of time for questions at the end so please ask those throughout also our speaker has provided some great further resources and tools so don't miss those in the resource widget that's on the left of your screen it's now my pleasure to introduce our speaker Charlene Richard Charlene is a registered social worker sorry registered clinical social worker in Calgary Alberta with specializations in addictions mental health and compassion fatigue she's also the creator of a program called caring safely which teaches
01:30 - 02:00 service providers and organizations how to prevent compassion fatigue Charlene has been teaching community provincial and federal organizations how to help prevent compassion fatigue since 2008 in 2015 she published a book titled 20 click strategies to help your patients and clients manage stress which included a chapter on clinician wellness so we're really thankful to have char with us today to share her expertise and to help our social workers across Canada with this really important issue so with that said I'm looking forward to this workshop and it's my pleasure to pass it
02:00 - 02:30 over to char hi Sally thank you for that and thank you for having me I'm always happy to chat about the topic of compassion fatigue and you've been happier to chat about it with social workers because it's always such a a great bunch of people to to connect with so welcome to the webinar how social workers can prevent compassion fatigue I think it's
02:30 - 03:00 important when we're learning information to just have a little bit of background in terms of the person who's providing the information as its based on their research their experience their ideology so just a little bit of information about me I am a clinical social worker and I'm also currently working in primary care in Calgary Alberta as a behavioral health consultant and so that means doing primary care mental health and primary care
03:00 - 03:30 my background is working with adults with addiction and mental health but I've been doing that since about 2005 and I took specializations and training over the years to focus on grief trauma and compassion fatigue some of the frameworks that I use our solution-focused I also use cognitive behavioral therapy dialectical behavioral therapy acceptance in Clinton therapy and some mindfulness based intervention and yoga I do some online
03:30 - 04:00 classes and online therapy for my private practice and I am also as Sally says the founder of care and safety which is an online program for compassion fatigue today you are going to learn some of the concepts of compassion fatigue we'll talk about the difference between compassion fatigue vicarious trauma and burnout and we'll go through the different phases of compassion fatigue the compassion fatigue come with a bit of a trajectory and this is a really good way for
04:00 - 04:30 understanding how it all begins because compassion fatigue often begins in a sneaky way that we're not really aware of so we'll definitely get into that we will review the signs of compassion fatigue as well as the risk factors and throughout the webinar we'll go over three different strategies that you can begin using to protect yourself and just talking a little bit about the the concept of caring safely is Roblin and what looks like for long-term sustainable caring but first I'd just like to know a
04:30 - 05:00 little bit about our lovely audience here so there's a poll up there if you guys want to take a minute to vote my question is how long have you been in Social Work and I'm sure we have a wide range so whether that is student less than two years if you've been in the field three to five years five to ten years or have you been in the field longer than ten years if you just want to take a moment or so to answer that
05:00 - 05:30 and we'll just go and see the results we'll check out who's in our our audience this evening all right okay so this one we don't have any students we have about seven eight percent less than two years eighty-three percent between two to five and about fifteen percent five to ten years and oh my goodness we have 50 and we're 54 percent people 10
05:30 - 06:00 years plus so we have quite the experienced Social Work crowd with us this evening that's fantastic my next question which sort of helps me gauge how in-depth to go to certain topics is have you taken any training on compassion fatigue or four so that's a yes or a No a there and I'll give you give you a moment to fill that out and then we'll check out the results all
06:00 - 06:30 right from time to time you may hear me drink a little bit of steam all right so we've got almost half and half is about 40 42 percent who have taken the training before and 58 percent roughly who have not taken a training before so this is going to be a great topic for us to dig into and when it comes to to teaching people things I think we could we could go into facts we could go into definitions but I think that story is
06:30 - 07:00 often a way that people maybe relate to an experience or understand it in a different way and definitely remember it more so through story so the concepts and the phase if I'm actually going to use through story and primarily I'm going to use my story and so my story with compassion fatigue begins actually before I was ever in social work and before I was in social work I thought that I wanted to be a
07:00 - 07:30 lawyer I grew up believing I wanted to be a lawyer and what did my first year of University I'm from Manitoba so I went to my first year of university at the University of Manitoba was a little too young and had a little little bit too much fun and didn't do so so well and thought well this is a big commitment in terms of time and money you know I should make sure that this is really what I want to do and I wasn't completely sure that law was what I wanted to do so I decided to become a legal assistant first and I became a legal assistant and began working for
07:30 - 08:00 the crown attorney's office in northern Manitoba in thompson's Manitoba and my job at in the crown attorney's office was to read through all of the files that all of the charges that were laid in the previous week not just in Thompson but also in the northern surrounding communities read through the file the and enter the details into the computer so that the crown attorneys would have that information with them in court and basically that meant I was reading anywhere from 20 to 50 files per
08:00 - 08:30 day that were all graphic in details about crime and many of them including trauma that had taken place and it was more than just details there were also victim statements there were pictures so I was being immersed in a lot of graphic details of trauma and I began noticing that I was having dreams about what was happening in the files of having nightmares of the things that have happened in the files were happening to
08:30 - 09:00 me and my family members I was my anxiety had started to get really high I was starting to see you know crime possibilities and danger everywhere so my worldview had started to shift and I didn't know at the time but those were experiences of vicarious trauma and so another interesting thing happened then actually two interesting things happened to it one of them was that doesn't look black eyes all of the time came out in 1999 and this was 2000 the end of 2000 beginning at 2001 and somebody left his
09:00 - 09:30 book in our office and so I started reading it and what it was was it was a book based on the qualitative study that had taken place in 1995 and Winnipeg Manitoba and it's the study involved 26 indigenous women and it was exploring their experiences of domestic violence first as they were children and then later on as they were wives and mothers and it also discussed their experiences within the court system and managable was doing a lot at that point in terms
09:30 - 10:00 of creating domestic violence divisions with the crown attorney's office and trying to support victims of domestic violence through the court process reading on that time the victim fill of Rights was passed in Manitoba and they came up with a position called victim service worker and so that happened while I was continuously reading the file that were coming in and for me I was fairly young fairly naive and extremely shocked at the amount of domestic violence that was taking place
10:00 - 10:30 in our community in the northern communities and so all of it happened at the same time and I realized I want to go in and help these people I don't I don't want to go to law until I see what the lawyers do I would rather do something else I want to be a victim service worker so what I was experiencing is the definition of compassion and there are a couple of different definitions that we'll look at in terms of references just so you know the references are on the last slide of this presentation which you guys have in
10:30 - 11:00 the resource and links section so MSF Allah says that compassion is defined as the emotional response when perceiving suffering and involves an authentic desire to help Kristin Neff says that compassion involves the recognition and clear seeing of suffering it also involves feelings of kindness for people who are suffering so that desire to help to ameliorate suffering emerges and looking at that that means compassion is containing two components it's
11:00 - 11:30 containing somebody who is identifying with human suffering as well as the desire or motivation to do something to relieve that suffering and that was what was building up in me during my time at the crown attorney's office I was experiencing compassion for the women and children primarily who were victims of domestic violence and I wanted to go in and do something to help and so I decided to apply to The Bachelor of Social Work program and I got in and my intention was to do my internship at the Women's Crisis Center
11:30 - 12:00 in Thompson and then to become a victim service worker so I got my wish I got into the Social Work program I got my first internship within the third year of Social Work and I got to do my placement at the Women's Crisis Center there were four different programs there we had a 24-hour crisis line and because we were the main city Thompson's often referred to as the hub of the Northeast Manitoba and we were also the crisis
12:00 - 12:30 line and the emergency shelter for all outlying communities in the north and so we have a 24-hour crisis line we have the 30 day emergency shelter we had a six-month transition program which was for women and children who had gone through the 30 day program and they needed more support while they were getting where they were deciding where they were going to live and so we actually have apartments and people women and their children would live in the apartments they'd have ongoing access to counseling we also had a follow up program which is for people who were not in the shelter but were
12:30 - 13:00 seeking counseling for domestic violence and so I say hello trauma work in there because now as a trained trauma clinician I know that what I was doing was pure trauma work every single person I worked with had complex trauma so not just a single incident trauma but that repetitive trauma that impacts people in a different way and one of the risk factors for compassion fatigue is not necessarily having the training that we need in our area so lack of adequate
13:00 - 13:30 training and supervision and I was going in there as an intern and I was actually I stayed on and did I ended up working there afterwards as well but with no trauma training so I was going in there learning how to do solution-focused counseling with people who had experienced severe complex trauma I also had no idea of what compassion fatigue or vicarious trauma was those were not words I had ever heard before I think imposed to work were often taught about burnout I don't know for you guys but in our orientation for
13:30 - 14:00 compacter of Social Work so first week in they had people come in and who had graduated from the program and they talked about this high level of burnout that tends to happen in Social Work and I think you know I can understand the concept of burnout but I didn't have a conceptualization for how you get to that what are the things that are going to happen before getting to this severe level of burnout which to me was something that indicated you weren't doing so well physically or mentally that you had to take time away from work other risk factors include overexposure
14:00 - 14:30 to trauma or pain or sufferings about ongoing exposure being early in the career so all those first four I definitely had going in lack of organizational recognition or protective policies so if the organizations aren't addressing the concepts of vicarious trauma or compassion fatigue a lack of community resources to support the people we are helping and sometimes it's
14:30 - 15:00 not that there's a lack of resources but the resources are so tapped out that they can't provide the level of service that our clients need and that's a risk factor because we often have the urge to try and make up for the deficiencies in in our system lack of self-regulation skills particularly when working with clients and we'll be talking about a strategy for that later and then are also our personal histories so do we have a history of adverse childhood
15:00 - 15:30 experiences we know that helping professionals tend to have a higher rate of adverse childhood experiences and we know that if a human is growing up in in conditions that are adverse that their nervous system is our brain it's all developing in a different way than if they weren't in those adverse experiences and so that means they're the nervous system is a bit more hypersensitive and we see that there's an adulthood connection to higher rates of physical health conditions mental health conditions addictions so
15:30 - 16:00 if we've got our own histories it could also be grief histories that we need to look at to see if we need to heal from that as well so these are some of the more common risk factors one of the things I like to check in with people is just to ask does your organization discuss compassion fatigue risk and protective factors so some organizations do discuss this I actually went on an interview one time this is probably about 10 years ago now in Ontario where
16:00 - 16:30 they had actually put one of the risk factors of the job this is the clinical social work job in primary care if they actually included vicarious trauma in there I was blown away that was the only time I've ever gone to a job interview where they actually addressed that so let's see what we have here oh my okay so we have 87 percent of people say that their organisation does not discuss compassion fatigue risk and protective factors and about 13 that does a great that we've got 13 hopefully over time we
16:30 - 17:00 start to see those numbers increase last year I presented at the Canadian Mental Health Association national conference in Toronto and so there were a lot of CMHA organizations from around the country there and I asked each person who came up does your organization address this and it was actually encouraging to see that some of them were really bringing in policy and programming around supporting those experiences for the first phase of compassion fatigue is the zealot phase
17:00 - 17:30 which really means no symptoms of compassion fatigue and it's usually the phase that we actually start in and so for me I got I got the Bachelor Social Work program I won and I got into the internship that I wanted I was doing was exactly on track and so we go into these organizations and we're so excited to to be able to help so we're very committed we're very involved we make ourselves available were we've got the energy to get into problem-solve and we really want to make a difference often we're putting in extra hours we've got a lot
17:30 - 18:00 of enthusiasm we're volunteering kind of willing to go that extra mile you know I'll do that I want you to just think of what were some of the things did you do during your zealot phase and I do these webinars semi regularly and I often ask that question and some of the feedback that I get from people will often it's working extra hours it's not taking breaks it's doing doing extra projects and for me I was very excited I
18:00 - 18:30 was going out and doing extra training to other organizations on awareness of domestic violence I was creating new forms and programs the group programming I revamp the entire intake form so we're just very excited about connecting with people and helping and this leads us to the concept of compassion satisfaction in compassion satisfactions of what the pleasure that we get from being able to do our work well so you may feel like it's a pleasure to help others through your work you might feel positively
18:30 - 19:00 about your colleagues and your ability to contribute to the work setting or even that greater good of society and I remember one of my first real experiences of compassion satisfaction it was when I was after my internship I took a position there working in the follower in the transition program so I was working with a woman who was actually living there and I was practicing my solution-focused work and she was trying to get her like her finances set in place and that had to do
19:00 - 19:30 with she had to work with social services around that and there were a lot of system barriers that were coming up as she was feeling really discouraged and so he did some solution-focused counseling around that what you know what are her goals what are her barriers how might she overcome those barriers and she left and then later on I think it was the next week I she came back in and she sort of had this kind of like glower energy about her and she said that the one of the anticipated barriers
19:30 - 20:00 had come up but she was able to work through it and she had achieved her her goal and for her that was really building it was very empowering for her I could see the biggest thing that that I noticed was that she had shifted from not really having much hope to hope that she was able to to experience success in reaching one of her goals and it really was empowering and for me it was such a good feeling it was almost like a high like I've done I
20:00 - 20:30 always talk about that juicy feeling of compassion satisfaction where we know we've really connected with another human and we've really helped them and that's the compassion satisfaction other people have described it as I really like having people get better it's really wonderful helping people I did make a difference I did make it better I'm in the right profession I should be here the rewards outweigh the challenges by far and there's no other feeling that can compare to really helping someone who is struggling these descriptions come from a study that was done in
20:30 - 21:00 Canada with healthcare professionals so it included clinical social workers nurses occupational therapists and so there are actual rewards that come from engaging in compassion feeling compassion and compassion leads to connection and with that there's actually research that shows that it can improve mental or mental health it can prove our physical health it's been shown to help speed up recovery of disease lengthen lifespan strengthen our
21:00 - 21:30 immune system improve our self esteem and lower anxiety depression and that compassion and connection leads to empathy trust in cooperation with others which leads to even more connections so sometimes I think about it now when I'm on the other side of compassion fatigue I'm in that ability to cross to sustainable caring and I think you know each day my job is to get up and help people so my you know my day today I have the ability to go in and as long as I can protect myself and keep myself
21:30 - 22:00 safe engage in this compassion with people and so I'm very grateful for the ability to to do that now on the flip side there is compassion fatigue which has been characterized by a deep physical and emotional exhaustion and a pronounced change in the ability to feel empathy for our clients our loved ones and our co-workers so there are different phases well we're going to go through those but it's truly a serious but natural consequence of working with
22:00 - 22:30 people who are suffering and traumatized I don't think someone can be a caring person can empathize with pain and suffering on a regular basis and not be impacted by it somehow other descriptions of compassion fatigue from our peers when you have nothing left to give you've given so much there's nothing left it's the cumulative tool that we as individuals experience as a result of exposure to suffering hardship crisis and trauma because of your kindness compassion and empathy you
22:30 - 23:00 start to absorb the emotions and reactions of the people you are helping and that concept of emotional contagion we're going to talk about that and how to help prevent that it's as though I don't have any more to give emotionally so I lose empathy for them I become cynical or just believing in what they say dealing with sick people and giving them what they need emotionally you just give give give all the time every time I'm at work I feel dread it's hard to fill my bucket in addition to compassion fatigue we might also experience by
23:00 - 23:30 carrieth trauma and so vicarious trauma there's primary trauma which means we directly are experienced a trauma ourselves on us and vicarious trauma or secondary traumatic stress is where the trauma has happened to someone else and we've either witnessed the trauma to them or they've shared graphic details with us and we are experiencing symptoms of post-traumatic stress disorder ourselves based on what we've we've heard from them so it's hearing their
23:30 - 24:00 stories the traumatic events the graphic details and often results in a shift in our worldview and our sense of meaning and this was something for me that had started back with the crown attorney's office so I was having a lot of symptoms of vicarious trauma back then I just had no idea what that was and at this point in my Social Work career I still hadn't idea what that was but some of the things that will happen are things like intrusive thoughts and memories so one of my more recent experiences of vicarious trauma happened when I was
24:00 - 24:30 working with a patient a young adult who was having one of her first experiences of psychosis and it was happening in clinic and she was extremely distressed about this and after getting her - we got her to emergency services for emergency psychiatry but after that throughout the day it's not like our day stops and were able to prop that we get the person connected and then we continue on because we've got more through it or schedule but throughout that day I started having the
24:30 - 25:00 the intrusive thoughts and memories about her experience you know what her face looked like the sound that she was making the distress that she was experiencing I was wondering what happened to her in the hospital I was wondering what would happen to her longer term knowing that a you know a diagnosis like that at a young age meant things could be difficult sometimes we experienced nightmares so I didn't have nightmares in terms of that experience but I many nightmares in terms of the other vicarious trauma psychological distress at exposure to cues so not
25:00 - 25:30 uncommon for people to start feeling distress at queues of things that could be causing trauma people may be medical social workers working in hospital settings they see a lot of people coming in from car accidents over time they might start experiencing anxiety about driving avoidance of thoughts and memories so humans don't like things that are unpleasant that's just the nature of being human and often when those intrusive thoughts and memories
25:30 - 26:00 come up we trying to avoid it somehow and that avoidance was often through numbing and so as we know many people numb through things like alcohol drugs food shopping gambling zoning out binge watching TV shows so we might turn to some of those less than healthy coping strategies to to manage that and then a change in the worldview so maybe before we got into the fields we thought the world was relatively safe but afterwards we lose
26:00 - 26:30 some of that so thinking people can't be trusted or the world is dangerous and if we work in a specialized area our worldview often changes within that area so I was working in domestic violence and I would actually when I'd be out at the mall I would see families and I'd start to think did I just see you know an indication of some power and control there within that relationship or with that child in terms of dating whether I was dating or friends were dating you know looking for those early signs of potential power and control we see a lot of social workers who are working in
26:30 - 27:00 child protection who are no longer comfortable letting their children go to certain places that maybe they wouldn't have had so much hesitancy before so our world view starts to change with vicarious trauma as well so we're going to jump actually right into a strategy and one of the strategies that can be helpful as something called limiting our trauma input and we know that the marks are the more trauma someone is exposed to the more likely that they're going to experience vicarious trauma so if you
27:00 - 27:30 have the option to limit the number of people you're working with per day who have trauma that can be helpful I've worked in organizations before where I worked with some people who had experienced trauma half my caseload had not so I could schedule my appointments with people so that it wasn't you know three people with a trauma background in one afternoon I would be able to move it around but then there are other positions where every single person you're working with his experience to trauma and that's what's the nature of it when it comes to informal debriefing
27:30 - 28:00 with colleagues I think when we're debriefing I think we often share more graphic details of the trauma than is necessary and if we could start being mindful of what kind of details were sharing with people isn't necessary then we're helping to reduce that amount of of details of trauma exposure to our colleagues but we can also start bringing that up as a topic with our colleagues as well as they are sharing more graphic details you know is it is
28:00 - 28:30 it okay to say was assaulted with a weapon or do we need to say what the weapon was do we need to say the way the assault happened do we need to say how long and where and what not sometimes for clinical supervision or whatnot we might have to but often I think we share more details than are necessary we also want to avoid or limit our exposure to real trauma that's happening in the world that either happens or were exposed to through the news radio TV internet social media when
28:30 - 29:00 I first started doing these workshops in 2008 I was not saying social media I think only half of us at Facebook at that point but now it's oh my goodness now people with their smartphones um they're actually live-streaming trauma as it's happening and then it's all over social need new saying you know click to see the live video of whatever incident and as soon as that happens unusually sending out an email or popping onto to Facebook
29:00 - 29:30 to people to say you know I know it's a human urge to sort of want to see what happened but can you limit your exposure to that do you need to see in here what is happening in those moments of trauma if you do want to connect on Facebook Sally was kind enough to go to my facebook page down there in the resources and links but you're welcome to connect with me there so the first strategy just start being mindful of the amount of trauma that we are exposed to or that you are exposed to so if we continue in the
29:30 - 30:00 zealot phase what happens is were we're giving we're usually working more hours we're not necessarily taking breaks and some of those lifestyle strategies or things that could be considered self-care that are actually really good resiliency factors for physical and mental health they often we don't have time for them anymore so we because we're working late we don't have time to go to that yoga class or to cook a healthy meal or
30:00 - 30:30 connect with family friends go for a walk around the block and in I mean we're doing all that extra stuff because the compassion is there we want to help all of our systems I don't know any country that has full systems that provide people with everything that they need most of our countries most of our cities towns that we're working in there's a deficit there there aren't enough services there so we're tending to go above and beyond to try and make up for that deficit which means
30:30 - 31:00 that we're working the extra hours and we don't have that time to do the things that would have normally helped us and not only that I don't know if you've ever seen this in your organization but the people who have been there longer they see the new people start who are all excited and full of energy and they're like hey why don't you work on this committee or why don't you take on this project so the extra requests start coming in so that zealot phase with limited boundaries means less self-care and less lifestyle resiliency factors
31:00 - 31:30 you put into that more trauma more empathizing with pain and suffering and start to get those compassion fatigue symptoms which brings us into the irritability phase and that might look like cutting corners you know avoiding clients we had many people that I've chatted with has sort of hidden from clients from time you know if they were if a client shows up in in a clinic and they're not there to see them they'd hide because they know what the Cornette follow them that they would want to go over and talk with them it might look like daydreaming being
31:30 - 32:00 distracted kind of thinking of the to-do list that needs to get done while working with people might start making oversights mistake hard to concentrate we might start distancing ourselves from our friends and co-workers and so you know are our resources start to deplete the more that we're giving in the less that were nourishing ourselves and what we tend to start to do is to pull away from people so that we can save all of our resources for ourselves than getting through work and I've definitely worked
32:00 - 32:30 with people who have said it takes everything in them to get in go to work function well people at work wouldn't know that they were having an issue but they would literally come home and get through the door and just sort of collapse on the floor until the dog comes over and licks their face like everything was being used to get into the work they get through the work day and then coming home there was nothing left the irritability phase can continue that image that you're seeing there it's
32:30 - 33:00 an example of what I'm thinking is dark humor that was on social media so I follow a lot of social workers nurses teachers on social media and this here the image says when your patient denies using drugs or alcohol and then the indication is you know presenting looking like that and as someone who has spent over 10 years working with adults who have addictions and mental health
33:00 - 33:30 issues when I saw this I had a visceral reaction to to this and I think that as we sort of continuing in the field when the compassion fatigue is starting sometimes people will shift into you know now they're mocking their colleagues or their moths and if you that they're working with they're having unfair talk about medical and mental health issues and that dark humor I think that people are often using it they're trying to use it as a protective factor so you you know you care about
33:30 - 34:00 humans you see so much pain and suffering and over time it it's painful if we don't know how to to sort of grieve and how to to counteract all of that pain and suffering and so that use of dark humor almost can put a bit of a buffer between people and so I think it's used as a protective or tempted to be a protective factor sometimes it's a workplace culture where that's just the nature of the colleagues in a certain
34:00 - 34:30 department or even a certain field and one of the questions I often get asked is you know how do I respond to that use of dark humor and I always say that you know it depends on the parents superb the person's level of personal resiliency in that moment so if you have the depending on where you are in terms of your sort of wellness you can either leave the situation where there is the dark humor or you can address it and there was one time probably about a
34:30 - 35:00 couple years ago where I was at a workplace meeting there's about 20 of us on our team and I was having a conversation with one person and I could hear a group of about four or five people close by talking and they were getting into some dark humor and one of the one of my colleagues there as soon as as soon as they got into that she said I don't I can't hear this right now I don't I don't want to be part of this conversation and she left and I'm still engaging in my conversation but I'm also
35:00 - 35:30 paying attention to what's happening over there and it was one of those things that I call a mirror moment so mirror moments being when somehow what we're doing is reflected to us so the way that we're being perceived as we're being is reflected from from someone else and we start to look at ourselves in a different way and I can see the people in that group who were sort of realizing that you know maybe this isn't healthy strategy or maybe this isn't you know who I want to be as a helper and one of the things that I say is that I
35:30 - 36:00 don't think helping professionals because I know they're very compassionate people I don't think when they got into the field it was - it was - to mock people or to engage in dark humor I think that you know authentically they care about people and so there are I believe other ways that people can other protective factors that people can engage in that maybe feel a little bit more authentic with who they are so if we continue in the irritability
36:00 - 36:30 phase which I did so went through a lot of the irritability symptoms went right into the withdrawal phase so that enthusiasm that was once there turned sour that bubble head first sometimes clients become a blur you know they kind of run together we're having difficulty remembering different details specific details could be seen as irritants and not individual so there's sort of a number in a caseload people might start complaining about us at work or in our
36:30 - 37:00 personal lives we start to feel tired all the time we don't want to talk about our work we don't want to admit our profession I talked about having a fake job so at one point depending on the field you're in but um I don't know if you have experiences but whenever somebody says oh what do you do and you say oh I work in until health ninety ninety five percent of the time they're going to get into a story about their own mental health concerns or somebody a family member's mental health concerns and this happens to me all the time it's
37:00 - 37:30 always at airports airports before I'm getting on an airplane used to make chat to chat with people and it kind of makes me giggle at how many times I've gotten Canadians told Canadians how to connect with mental health services in their city that's going to be a difference with events than we're in but back then I used to also make jewelry and sell it out of a friend's hair salon and I would just tell people I made jewelry I didn't want to admit that this is what I do we would we sometimes neglect our family and friends co-workers I had a thing
37:30 - 38:00 where that I said I'm on a need-to-know basis a need-to-know basis was an indication that unless somebody is seriously ill or something is on fires do not contact me and I would tell my closest family and friends I'm on a need-to-know basis and I wouldn't say it for a day or two I would be looking at my schedule and everything for the next 11 days I am on a need-to-know basis so I was completely pulling away trying to use every resource that I had to get through because it was my BSW at the time I was
38:00 - 38:30 working a couple of different jobs than one of them was at the shelter so if we continue on we're likely to shift into the zombie phase and so the zombie phase is where we shift into autopilot we're not really connected with our thoughts and feelings were disconnected from colleagues or peers or family and friends we've often lost compassion for the people that we're working with you know we hear what they're saying but we're not deleting emphasizing anymore
38:30 - 39:00 we sort of lost our meaning and our value as helpers and for me so I went through my Bachelor of Social Work degree I was in the withdrawal phase by the end of the bachelors social work program so my bachelor finished in June of 2008 and then I had gotten accepted to the wilfred laurier advanced standing clinical social work program which was a more intensified program so that we could get all of the the internship and
39:00 - 39:30 the course was done in one year and so I got into about starting September 2008 so I had about three months off in between it also meant moving about 3,000 kilometres away to a place that I didn't know anyone so it was should exactly your relaxing summer but when I went back to or sorted when when I got into or certain about Laurier or schedule with three days a week three full days a week at our internship and then two days a week doing a full course load for the term and I went back in at about the
39:30 - 40:00 irritability phase so I wasn't even back into the zealot phase by the time I went back into the work there so very quickly went from the irritability phase into the withdrawal phase was about six weeks in where I actually ended up developing panic disorder and I had my first panic attack while I was in my Social Work classroom for the course use of self and it was bizarre experience because I had worked with people who had panic before I knew the textbook symptoms I was actually self diagnosing it as it was happening but if anyone's ever had a
40:00 - 40:30 panic attack you told an extremely intense experience ended up having my second panic attack the next morning on the drive into to my internship and so developed panic disorder from there so that was more so getting to the to the burnout phase and that was six months into my master's degree so once we get to this level there's one I should mention at that point I still did not know what compassion fatigue or vicarious trauma was nobody had used
40:30 - 41:00 those terms with me and so there's two different ways that we can go there's there's burnout which is where we're often overwhelmed we have physical health conditions mental health conditions or they're shifting into sort of mature and renew so there's the term that I've created is called sustainable caring so burnout is when it's extreme circumstances it describes anyone whose health is suffering or whose outlook on life is turn negative because of the impact or overload of their work their signs and symptoms or chronic and
41:00 - 41:30 physical illness has developed brief interventions no longer help psychological and or medical assistance is necessary so the other option or sorry the professional quality of life screening tool which is actually you'll see in the resources that there is a screening tool for compassion satisfaction and compassion fatigue just burnout is associated with feelings of hopelessness and difficulties in dealing with work or doing your job effectively these negative feelings usually have a gradual onset and can
41:30 - 42:00 reflect the feeling that your efforts make no difference or they can be associated with a very high workload or non supportive environment the day to day experience of compassion fatigue I talked about dread for work I talked about Sunday night dread often people start to have that dread Sunday night about going out on Monday and then to get emails from people saying no it's Monday morning dread it's Sunday afternoon panic attacks like when we're in that high level there's often that
42:00 - 42:30 threat of or just going into being able to face the day people are often d dreaming about new jobs looking for new jobs we are canceling plans of family and friends calling inspect more often experiencing more illness and this is also one area to to reflect on if we do have our own background of adverse childhood experiences depending on what our level is we might have higher rates of illness and so the ongoing exposure in terms of the stress and the trauma at
42:30 - 43:00 work can be impacting that as well sometimes people will shift into the whole mindset of if it's not trauma then it's trivial or it must be nice I know one time this is a so do my Bachelor of social work I was out first MS those working in the women's shelter and I was out for dinner with a friend a very close friend and her and her boyfriend were having some some issues nothing major he was often late to pick her up or sometimes you know wasn't following
43:00 - 43:30 through with her plans that she was talking to me about that and I remember how she was telling me because he had been late again to get her I remember thinking well it must be nice that the biggest issue in your relationship is that he's late to pick you up because everybody that I'm working with has experienced extreme violence from the person they're in a relationship and then I just felt terrible afterwards I just felt so guilty because for her it was a legitimate issue and I had sort of shifted into that you know it must be nice if that's all you're dealing with
43:30 - 44:00 because it's not trauma and that's what I was immersed in we talked about some of the you know how do we adapt or how do we sometimes what our unhealthy coping strategies a lot of for a lot of people it's emotional eating it's drinking what excessive TV sleeping a lot sometimes we talked about annoyance with patients clients students colleagues I put so needy in brackets because that once I did learn about compassion
44:00 - 44:30 fatigue vicarious trauma and started coming down from it that so needy feeling was one of my warning signs that my compassion fatigue was starting to rise because there would be times where I would just get this feeling like oh my goodness a person is so needy and then I would say to myself of course they're needy they are in need that's my role is to provide support for that but that was an indication to me that thing needed to change in order for me to get the compassion fatigue back down often higher generalized anxiety sometimes if it continues on to the point of that
44:30 - 45:00 numbness when we just don't care anymore we don't have that empathy and the last one is to me it's one of the scariest symptoms of compassion fatigue which is that loss of hope so I believe often our role is to be the holder of hope for the people that we're working with because often they've lost that hope and they need someone to hold that for them until they can get that back and when we start wondering you know am I really making a difference what's the point for me I
45:00 - 45:30 felt like such a hypocrite I talked about crying on the way into work and so that was when my panic attacks were were very high but literally crying on the way into work and then thinking about you know the irony I'm I'm the person who's coming in to help you today you don't know this but I was crying on my way into work so it can big range in terms of how it will show up for people the other option is this concept of sustainable caring that I've created so
45:30 - 46:00 caring is defined as things that are done to keep someone healthy and safe whereas sustainable has been defined as being able to be used without being completely used up or destroyed and when I put the stainable caring together is to me is being able to consistently provide compassionate care with resilience to the pain and suffering of others so when I now practice sustainable caring to me that means that I can go into work each day I can
46:00 - 46:30 provide compassionate care I can emphasize with people who are experiencing pain and suffering I can use my skills to my resiliency skills to to manage some of that through emotional regulation and other things and so I can provide that care to those people who are been tainted who are suffering but then I can also go home and be happy about the things that I have in my life and have the energy to go to yoga and to connect with friends and to do um to
46:30 - 47:00 cook whereas you know once upon a time it would you would come home collapse on the couch and just get up and do that in the next morning so a couple of different ways that we can start building up our capacity for sustainable caring and in terms of personal protective factors we can look at our lifestyle one of the frameworks that I use with with people is that from the time we wake up to the time we go to bed everything we do is either something we are giving or something that we are getting in terms of of nourishment and
47:00 - 47:30 so ping ping extreme attention to how much giving how much nourishment how will we managing that how are we getting more of how we're getting a daily nourishment that we need if we have personal healing that needs to be done whether that's past losses or past traumatic experiences that we need to work through with with a therapist I think that's really important the assertiveness and boundary skills that's huge there's there are a few different reasons why helpers tend to struggle with saying no one of one of them is
47:30 - 48:00 that helping helpers often think that if they say no that they're appearing selfish if they say no they might feel guilty for saying no and some struggle with some of the the fear or anxiety around the potential conflict of saying no to people for all of those reasons we sometimes struggle with saying no which means we say yes a lot more often and then we don't have the time to to do
48:00 - 48:30 what we need to do to take care of ourselves we also can start practicing with emotional regulation skills particularly if we have a background with adverse childhood experiences or working with a lot of trauma and we'll go through a strategy for that shortly professional protective factors so training and education in your field right we need to know how to help the people we're working with and the more skills we have the more confident you feel in that knowing how to protect
48:30 - 49:00 yourself from emotional contagion and vicarious trauma so that's what emotional regulation skill will talk about if clinical supervision can address compassion fatigue that's ideal when I've provided supervision or mental health consultation with organizations I've always included compassion fatigue as part of that in time particularly my first five years in social work after my MSW if I wasn't getting the level of clinical supervision that I felt was necessary in
49:00 - 49:30 my workplace I actually paid for external clinical supervision because I had identified it as such a strong protective factor for me and managing compassion fatigue and it get a little bit more choice when you're paying for your clinical supervision in terms of how it's used and so I always included a back component of checking in on my compassion fatigue if there are workplace policies promoting compassion fatigue protective factors that help if we can get pure support from our colleagues so both for the professional
49:30 - 50:00 support in terms of sometimes we just need to check in with people in saying oh did I miss anything doesn't seem right to you but we also benefit from that personal empathy so you know a colleague empathizing with what we've witnessed in terms of the pain and suffering because people outside of our fields don't really understand there's a lot of stigma around social workers there's a whole concept of you know baby Snatchers or their stigma about the populations that we are helping me working in addictions for ten years when
50:00 - 50:30 I have some people have in a society have opinions about addictions being your personal choice as opposed to a mental health condition and so getting that connection from our peers can be really helpful and also the ability to grieve the pain and suffering that we see in our clients because we see a lot of it and we see a lot of deficiencies in the systems that are supposed to be helping them and I truly believe that we need to be able to to grieve that pain
50:30 - 51:00 and suffering as well as a really strong part of staying in their work and still being able to practice that sustainable caring so the professional quality of life scale we aren't really going to go into it too much you've got that down in the resources and links but that will give you your scores of compassion satisfaction burnout and a secondary traumatic stress or compassion fatigue it's a self scoring test so you'll be able to see the score within that
51:00 - 51:30 all right so strategy number two is to practice emotional regulation and the purpose of practicing emotional regulation is to prevent the emotional contagion that can happen and as humans we have these things called mirror neurons so I'm just going to have a sip of tea for me so as soon as we have mirror neurons which means that when we're seeing someone or when were with someone we can mirror their emotion we
51:30 - 52:00 can catch their emotion so to speak if you think about actors and movies their job is to have you feel an emotion based on what they are portraying in terms of their face and their tone of voice and and their body language and so we can catch these emotions and there are some people who feel a little bit more susceptible to to catching emotion so you know if they're around somebody who's really angry they start feeling tension in their body maybe heat in
52:00 - 52:30 their body if they're around someone who has depression or intense grief and they're very sad they can feel sort of a heaviness and you know kind of a weight bearing down on them if there was somebody who has maybe PTSD or panic disorder really high anxiety they might notice that their nervous system has been triggered and they're feeling some of that anxiety agitation shallow breathing rapid heart rate so you want to to start paying attention to the warning signs that your stress response has been triggered when you're working
52:30 - 53:00 with someone and if we don't learn how to do that we basically become like we're on a roller coaster most of the day and that means that we're feeling whatever's coming into our office or whatever we're being presented with and that's what was happening to me because again I all the way up until near the end of grad school I didn't know what compassion fatigue in vicarious trauma was I didn't know about emotional contagion and regulation and how to practice it with clients present so if
53:00 - 53:30 so I would literally be up and down in terms of the emotions and my nervous system was just all over the place so you want to watch for signs that your stress response has been triggered now whether that means you notice your heart rates going a little bit more quickly maybe tension in your jaw your shoulders are up by your ears maybe your tensions and your stomach is holding tight there could be some shallow breathing that means those are indications that your stress response has been triggered and that more often happens with anger and anxiety and fear so if we're around
53:30 - 54:00 those we want to watch for that and then we want to do something to trigger the relaxation response so the stress response is coming from the sympathetic branch of the nervous system we want to do a practice to trigger the parasympathetic branch of the nervous system and we can do that using our breath but it's important to note the difference between deep breathing and shallow breathing so with a deep breath when you inhale your belly should be coming out with an inhale the belly needs to compose so that the diaphragm can drop and the lungs can fill up some
54:00 - 54:30 people will take a deep breath and their chest will come up really high they'll take in a lot of oxygen but their bellies going in and so that's not a true deep breath because the lungs aren't truly filling up that's shallow breathing and the science behind it is that it's on the exhale of a deep breath that you trigger that relaxation response you're triggering the parasympathetic branch at the relaxed the parasympathetic branch of the nervous system on that exhale but what this means is you want to be able to
54:30 - 55:00 trigger the relaxation response while you're with people but it can be a little bit um it can be a little bit it makes me feel a little bit preoccupied or distracted when you first start practicing it so ideally what you want to do is you want to start practicing alone in the resources there's a handout there for the deep breathing that will kind of walk you through the steps there's also a guided audio for deep breathing there and so you want to start practicing when you're alone just so
55:00 - 55:30 that you can start to feel what it feels like for the belly to expand and I know when I first started practicing this with my therapist I literally could not make my belly go out like I was pushing it out no matter what I did I cannot get my belly to expand and if you struggle with that one of the things you can do is lay down on your floor on your back and then when you're breathing you can look down to see as your chest rising or as your belly rising and sometimes that makes you feel a little bit more relaxed it allows you to let to that belly relax
55:30 - 56:00 and expand with the breath but you want to know what that feels like so that in any given moment if you remember to do a deep breath you would be able to feel that without having to put you know one hand on your belly to see and then you want to start practicing it when you're around people and you might not want to start with clients right away but you might want to start with your family members the people at the grocery store or the coffee shop when you're watching TV you know especially if you're watching shows that are evoking certain emotions in you you want to start
56:00 - 56:30 regulating while you're engaging with people and then you want to start practicing while you're with your clients and there's a little thing I know that's a sticky note reminder which is really a behavioral activation cue that I often use with people and what I say is take a sticky note and put it somewhere in your office when you're going to meet with your clients somewhere that's in your line of vision when you're looking at your client and that sticky note is a reminder for you to check in while you're with them and make sure that you're doing belly
56:30 - 57:00 breathing make sure that you're regulating your nervous system and if it takes process but eventually you'll be able to keep yourself regulated while still being completely in tune with your client and emphasizing with them so you can empathize with them but you're not catching their emotions and so that's going to be one of the strongest ways for you to start protecting yourself from the vicarious trauma from the ups and downs of all the different emotions that come in throughout the day oops
57:00 - 57:30 alright so strategy number three increasing personal awareness for change this is where the long-term change comes in because you can learn you know one or two strategies and you can start practicing them and they can help but I think if if compassion fatigue is something that you identify with and it's something that you sort of struggled with off and on in order to create that long-term change we need to increase our personal awareness and I
57:30 - 58:00 say that because there are a lot of things that we do as individuals as clinicians and social workers throughout the day that contribute to compassion fatigue and and is certainly not all personal as there are a lot of system reasons organization recent resource reasons workplace stressors that contribute as well but in terms of what we have control over we have control over some of the things that we are doing and so our thoughts our feelings our urges and our choices / behaviors impact our
58:00 - 58:30 wellness and compassion to take many times throughout the day so that's part of my framework of everything we do is either a giver or a debt in terms of of nourishment and if we're constantly choosing to to give and have an output and we're around things that are causing higher stress the higher the stress we have the less clarity we have and the more stress we are the more likely we are to perceive things in terms of crisis that maybe aren't crisis and we become more reactive in our behaviors so
58:30 - 59:00 this example is actually one that through caring safely we we always talk about how do you prepare for the holiday season in terms of setting yourself up for success around compassion fatigue how do you prepare to leave and then how do you prepare to sort of ease back into it after holidays and so this was an example from one of our members and so the the thought was he has a history of stress around the holidays I'm scared the stress will increase his risk factors and so the urge she says I have
59:00 - 59:30 the urge to call him before I leave for holidays so she calls him Friday afternoon he becomes distressed on the phone so now she has to call police to have a safety check done because he's gotten off the phone and she can't ensure his safety so now she has to stay lead and wait for the safety check to happen and then she has to document it so she goes home worrying about that and doesn't have the energy to go - which would have been the yoga class the beginning of her time off so without
59:30 - 60:00 sort of the the personal awareness of what happens with thoughts feelings urges and choices plus the higher stress this is what happens so the strategy 3 is increasing personal awareness for change different ways that that can be done for sure mindfulness meditation is a fantastic way to increase personal awareness its purpose is to help people become more aware of what they are experiencing moment to moment without judgment and what that means is what are they
60:00 - 60:30 experiencing in terms of thoughts I've read different research that says adults have anywhere between 14,000 to 68,000 thoughts per day we're not aware of those thoughts were often much more reactive to them so mindfulness meditation helps us recognize what thoughts are coming into my stream of consciousness what am I feeling in my body what emotions are coming up what urges do I have so it's a really strong way to increase personal awareness it also fosters empathy reduces emotional reactivity to painful stimuli Yoga is
60:30 - 61:00 another way to increase our personal awareness it creates some force or increases more of the mind body awareness and will also trigger the relaxation response I think yoga can help to move emotions through the body Yoga is definitely something that I use as part of my ongoing sustainable caring practice I use yoga a lot to move through the grief that I experience in terms of what I I see with people and so I instead of
61:00 - 61:30 trying to you know stuff it or ignore the pain and suffering that I see I'll let myself on a regular basis is there something that really you know stuck out for me experience that and yoga will be a wage for me to help sort of move that through or therapy working with a therapist can help you understand your work through any struggles that are related to boundaries or fear of conflict if we have to do our past you know our healing about our past experiences but we're ideally through
61:30 - 62:00 therapy learning more about ourselves again those thoughts those urges those emotions and how we're managing them so with increased awareness this is sort of how the before and after happens for for our member we looked at the situation and so the original thought coming up is he has a history of stress around the holidays I'm scared this stressful increases risk factor I have the urge to call him before I leave for holidays so
62:00 - 62:30 we already know what would have happened you know prior to this is what would have happened but now with the increase awareness of the whole process of compassion fatigue and what stress is doing in terms of perception so with the awareness of the thoughts the feelings the urges instead of reacting she pauses and she thinks I know I've been stressed trying to wrap things up for the holidays so to her that meant I know that I'm potentially perceiving things as a bit more urgent I met with him
62:30 - 63:00 three days ago we have a full safety plan in place for him over the holidays I have no reason to suspect crisis so while going through that kind of cognitive processing she was also engaging in emotional regulation so working on bringing her stress response down triggering the relaxation response and then logically going through is being that three days ago she created a really good plan with him to help him through the holidays so that means no calling so she doesn't call him over the
63:00 - 63:30 holidays so to speak and then definitely doesn't have to do a safety check she can leave on time she has the energy to to kind of go home and participate in yoga and continue on so that's how increasing our personal awareness can start to change a lot of small behaviors that can add up and contribute to compassion fatigue over time so how social workers can prevent compassion
63:30 - 64:00 fatigue so the first thing is the concepts there are more concepts that we didn't get into but so there are different concepts like vicarious post-traumatic growth others you can learn more about do more research on emotional contagion conscious versus unconscious empathy but the core ones being what is compassion fatigue with this right here is trauma what is burnout and really knowing the phases as well you know identifying with what
64:00 - 64:30 phase were in I think it's very fluid often sometimes when we get down to sort of that zombie phase and definitely burnout we're sort of there and it's really hard to get out of that but at other times we can be a little bit more fluid going up and down the scale and then trying to figure out within that scale you know the more and more you bring yourself out of it the watching for those warning signs so what ended up happening for me was by October I had panic disorder by January February not
64:30 - 65:00 doing well at all I had decided that I'm going to leave the field I'm going to finish my degree in June but I'm leaving the field I can't do this I don't recognize myself anymore I haven't lasted forever I feel terrible I dread every single day I'm just going to do what I need to do to get through this and then I'm out which was fairly scary because I was meeting with tens of thousands of dollars of debt and my thoughts were I'll go back to serving if I have to assess not as bad as what I
65:00 - 65:30 was experiencing so I actually ended up in that maze about February I made the decision that I was going to leave in June but in May I went to a workshop called compassion fatigue vicarious trauma burnout and within the first hour of that workshop it was like it was amazing I thought this person is speaking my life this is my day today and right away I went all the way back to the vicarious trauma that I had started experiencing in the crown attorney's office and then how all that
65:30 - 66:00 continued on through my work in the women's shelter and then into my work doing counseling through the through my internship with grad school and I knew that I wasn't going to recover right away it wasn't going to be just poof now now I know how to handle it but I knew that I now knew that there was a framework right I had an understanding I had a conceptualization for what was happening and I knew that if that was out there there must be ways to manage that and so I've fully immersed myself into
66:00 - 66:30 the concept of compassion fatigue and started bringing myself back through the phases so I was at burnout kind of come back down into - zombie into withdrawal into irritability and then into the zealot phase and that zealot phase is so at this point you know I'm usually in the zealot phase but sometimes I could slip into the irritability phase and so my warning signs are a few things that happen in the irritability phase and the majority of a time I'm working from what I refer to as a protected zealot phase
66:30 - 67:00 because even ten years later I will get so excited about the work that I'm doing in the way that we can help people that I'll start taking on more I'll say well we can do this I mean for me being able to do mental health and primary care is phenomenal the impact that I can have with physicians and the amount of patients that I can reach I start getting excited but then I know when I take on more that's when I'm setting myself up to the compassion fatigue so for the irritability phase so know your phases check your scores on the scale you can do that you know regularly once
67:00 - 67:30 a month you know quarterly start practicing you limiting your trauma input particularly if you have any anxiety because anxiety is extremely creative and it will pull details of trauma and personalize them for you in terms of how could this happen to you or your loved one practice safe empathy so that entire concept of emotional regulation while empathizing with people is one of the strongest ways to to start
67:30 - 68:00 bringing down some of that compassion fatigue on a regular basis increasing your personal awareness and whatever form that you would like that to be and seeking additional support if needed so doom is there healing that needs to be done do you need to connect with somebody to support you to support you your your mental we'll help in a different way so that would resolve that is how social workers
68:00 - 68:30 can prevent and start preventing compassion fatigue so it's been my great pleasure to share that information with you if you want to contact me you can get me through email we're definitely gonna have questions right away so I'm sure Sally's been collecting questions throughout this process but if you need to contact me after the webinar info at charlene richard RSW comm and both my
68:30 - 69:00 website so charlene richard RSW calm or caring safely dot org I think this is where Sally pops back in it is indeed and I first of all I mean so thank you so much for doing this presentation for us I think it's it's so core to everyone's practice and I was blown away by the poll results so clearly this is something you know we need to keep generating dialogue around and you know a big thanks to for posting your information on there so people can get in touch with you afterwards if they if
69:00 - 69:30 they need to but yeah we're going to get into audience questions right away I have a bunch I want to apologize right away if we can't get to everyone's but now I'm going to get right in I'm going to start with one that goes into a bit of an experience and I just because I I can feel I can like this really feel the pain that this person that has in their question and I and I hope you can speak I hope you can speak to it and she says I had to go on disability for a year due to anxiety and depression from my job my
69:30 - 70:00 agency couldn't couldn't wouldn't provide supports for me with a high-risk case I'm back at work but after going through this webinar I think I may still be dealing with compassion fatigue I try to avoid hard situations and letting my self care too much will I ever be able to have meaningful impact on my clients and have passion for my job again excellent question so it's interesting with me working in primary care now the majority of people who get referred to me is for anxiety and/or depression and anytime there's a
70:00 - 70:30 helping professional who has anxiety or depression well for starters it's not uncommon to get to the point where I leave is actually necessary and I think sometimes I'll leave ethically we need to leave at some point what we're experiencing in terms of depression and anxiety is impacting our ability to care and ethically we should not be providing that care the difficult things that physicians don't often identify what compassion fatigue is so somebody starts
70:30 - 71:00 getting treated for depression and anxiety Austin that's medication that can be therapy for depression and anxiety whatever therapeutic method is happening is that cognitive behavioral therapy acceptance and commitment therapy we look at cognitive restructuring we look at you know mind-body strategies for emotional regulation all of that great the person symptoms for depression and anxiety start to be relieved and they go back to work now compassion fatigue is different it's not a diagnosis I can't resort or there's no
71:00 - 71:30 diagnosis for it it often does end up if not managed into the depression and anxiety but from what we talked about tonight I'm hoping that you can see that there are other things to be done in terms of regulating while empathizing and looking at how to to sort of balance some of those things that we might do personally in better impact our work as well so I guess this is what I'm trying
71:30 - 72:00 to say is absolutely you can get to the point where you can feel passion for your work you can connect with people you can practice that sustainable caring but it's going to require things that are a little bit different from the strategies that are there to manage the depression and the anxiety so I hope I hope that speaks to that no I think it I think it definitely does and I was I was hoping that you were going to give a sigh I knew I knew you were going to give a hopeful response so I hope that was helpful to the person that asked
72:00 - 72:30 that question I'm going to skip over to something a little bit different it's about stigma and the question begins with Vault prayers for you well done Charlene you really know what you're talking about when she says they need to educate social workers and Social Work students that this is a career that needs to be managed upfront as you will be impacted my readings and experiences I stopped using the term burnout which was used in the 80s and in my day this term seemed to have more of a stigma that there was something deficient or wrong with you as a person versus you know the natural consequence of this type of work I now
72:30 - 73:00 use the term chronic or cumulative stress so what are your thoughts about the stigma associated with this terminology kill huge there's still so much stigma around the hood term yeah like to the term compassion fatigue and and very true in terms of burnout my understanding in terms of Baroda said it more so originated that this in this field it wasn't necessarily something that was brought into helping field so
73:00 - 73:30 the stigma is there I think part of it is there from us us not wanting to to admit that we're being impacted by the work there's a sort of society belief about can you tough it out there probably this was probably about six or seven years ago but I was in the subway in Toronto and they were advertising to hire Child Protection workers there and that I can't remember what the image was but the message was are you tough enough
73:30 - 74:00 to handle it and it was all about this sort of are you tough enough to go in and be a helper and you know to me that's sort of setting the stage or you need to go in to be tough and to handle it you need to be there for other people as opposed to when I talk about compassion fatigue as normal to me it's something I think that every person who is caring and in a field where you're helping people who are in pain or who are suffering you're going to experience it at some point you might only ever get to the irritability faith and not
74:00 - 74:30 identify with it too much or you might go all the way through to sort of that zombie phase so still a lot of stigma stigma from management for sure depending on sort of their background it's not uncommon for management to actually not have a helping background so they might not understand the actual impact of the work and so I see this a lot in you know like hospital settings and health care where they're sort of
74:30 - 75:00 spoken down to about oh well then they're going to get burnt out you know that there's sort of recognition that particularly in mental health and Social Work fields there is a higher and launch of fixed time that's just the nature of it but what the managers don't understand is these helping professionals are using empathy as a tool to connect with someone and help their healing without that emphasizing and validating that person isn't going to heal and so we are using our emotions to do that and that is absolutely going
75:00 - 75:30 to have an impact on our health but if we're not normalizing that and talking about it and there's still stigma around us being impacted by that right oh yeah no that's a oh that's a great answer I I'm going to I'm going to jump again to something that we got a lot of questions about a lot of different kinds of questions but I'm going to kind of combine them into one it was about what you mentioned about dark humor so I guess do you ever think there's a place for dark humor or is it ever a useful
75:30 - 76:00 coping mechanism yeah I have a feeling there d a lot of questions for having dark humor like I do think that if people are using it as a protective factor that is giving them a bit of distance from the people that they're helping who are in so much pain I guess my belief is that there are healthier ways to cope that are likely more authentic with who we are when we are feeling well and when we are sort of
76:00 - 76:30 resonating with why did we get into this field to begin with and I think that as the compassion fatigue bills over the years we start to lose connection with that right we start to lose that compassion satisfaction we were exhausted and that just becomes one of the ways that we have to to cope so for for some people they they say that it's it's helpful for them my invitation would be are there other ways that might be helpful as well that that might
76:30 - 77:00 replace it and then when I come to my behavioral health background it's what if you did an experiment to see what a different coping strategy is like how would that feel for you would that feel any different right Yes No definitely um okay another question about about knowing yourself I guess in the role and kind of about hope so they ask in your role working with people that are experiencing these things is
77:00 - 77:30 there ever a time where protecting yourself just doesn't work I guess I'm asking is there a time you recommend someone get a different job or leave the field perfect question yes so one of the things that and this is kind of one of the conversations we have a lot in terms of caring safely is if if you learn about compassion fatigue if you learn about different strategies to to protect yourself and if you use every single strategy that you have but you
77:30 - 78:00 are still feeling the signs and symptoms of it then that's likely the time to leave and there are absolutely organizations out there that they sort is sort of a revolving door they're going to get people in for a certain period of time and then eventually they're going to leave and there that's just what they're used to so it's not how can we help people develop sustainable caring it's what can we get out of you while we have you here and so I mean even myself there's been two different organizations that I've worked
78:00 - 78:30 in and the way that it was set up I knew I knew early on that the signs and symptoms of compassion fatigue were coming back it was the amount of it was the amount of trauma that I was working with on a daily basis and I had had said okay wow I'm you know eight weeks in I can already see my symptoms coming back I'm going to put every single strategy that I have in a sand duty all of the extreme sustainable care and practice that I can do and then we'll see what happens and six months in or four months
78:30 - 79:00 after that I knew this is not a sustainable position for me you know somebody else might be able to do this but me my background my experiences um I can't at this point sustain this work and so that's when I started looking elsewhere and it took about three months to get connected to another position so sometimes it's maybe us our background and a position that we we cannot sustain and sometimes it's the organization who they just they do not make it sustainable they give you a quotas that is just not sustainable and
79:00 - 79:30 they know that you will come and go and at some point yeah and there's been a couple people in caring safely who have said you know what I gave it my all for a year I've done everything I need to leave and they feel better leaving because they know they've done everything that they could to name compassion fatigue and vicarious trauma and to try and work through it well right I so I I think we have time for about probably two or three more questions but and I kind of selfishly want to ask a question of it that I that I want to ask right now just quickly
79:30 - 80:00 which leads expect leads from that one you just answered of course these are these are incredible strategies to help individuals cope and they're going to really benefit people and caring more safely but our role here at csw courses is advocacy on the federal level and to try to address some of this we're currently pushing the federal government to include social workers as first responders and PTSD legislation so it's like one thing we're doing but as an expert in this are there other system changes that you would want to see or that you think would be necessary to kind of help you
80:00 - 80:30 know if not completely address and mitigate these issues so I mentioned how that one organization included one of the risk factors of the position of clinical social worker in primary care was vicarious trauma and I think that it here's where I think it's going to really get interesting as Canada starts to implement more of their psychological health and safety I think that there's a very good place for the concepts of
80:30 - 81:00 vicarious trauma particularly the exactly what you guys are going for the first responders the the presumption of a PTSD diagnosis based on the work that's being done and so I think that as psychological health and safety comes in the importance of having those concepts within that and addressing it cuz I know early on when we're looking at psychological health and safety its oh do you know the basics of anxiety you know basics of depression do you know how to manage stress but for the helping professionals the first responders I
81:00 - 81:30 think that the legislation needs to be in there for the exact same type of stuff that you guys are are advocating for and some organizations are getting ahead of it so before there's the actual legislation there already to bring in practices I get to talk to you to a lot of managers around them wanting trained to come into their organization or they talk about licensing my program for their staff so they're getting ahead of what I'm hoping at some point actually does become legislation in the sense that we do need
81:30 - 82:00 to name it and to start looking at ways to to address it as opposed to keeping that stigma and shame around us right right and now that I've successfully made you address micro and macro issues I will go through some more practical things okay this is a this is a big deep one I always struggle with the fact that I think deep true and empathy is key to social work but it's also something that
82:00 - 82:30 contributes to vicarious trauma and compassion fatigue is this something you wrestle with is there a way to actually practice without ever having negative symptoms so one of my first training says the compassion fatigue specialist um I actually took my training through the traumatology Institute with dr. Anna Baron MC down there and so a lot of brilliant brilliant trauma therapists she's I've taken other training with her as well if you have the ability to train with her sheets is fantastic she talked about the whole concept of Sybil edge stored of sort of caring and so I had
82:30 - 83:00 mentioned how I truly believe empathy is one of our greatest tools and it's why we help people move through change when other helping professionals don't and I think a big part of that is we truly sit with the pain and we validate their experience with that and then it helps them move into action - to begin the healing so this is where I also think that you can't emphasize with that
83:00 - 83:30 amount of pain on a regular basis without being impacted yourself so key for me is to to practice safe empathy which means I'm consciously empathizing with this person and I'm doing emotional regulation while it happens so I'm in control of my nervous system while I'm tuned in with them and then this is where comes in to that concept of grief where I truly do need to let myself the old sadness for what this other human is experiencing has experienced
83:30 - 84:00 and might continue to experience and I need to let myself feel that sadness so that it can come and go so acceptance and commitment therapy is sort of focuses on the fact that you know if we accept something it's going to come and pass much more easily than if we try to stuff it down and so learning a way to move through that the griefer or whatever the experience is it doesn't mean that I'm not impacted I am but I
84:00 - 84:30 think it stuck I don't hold on to it anymore it's not something I'm trying to manage it comes and it goes and to me there's no stigma without it also if that results with me in shavasana on a Friday night with a couple of tears coming down my my cheeks that's not a bad thing that's me as a human having emotion letting it come and go so that I can go in the next day and continue to care about the other people right I think that's that's just so helpful I think we have time okay we have time for
84:30 - 85:00 one more and I think it's a good one to sum up with a good takeaway I guess someone asks how do I know if when I'm feeling is compassion fatigue or if it's something larger in my life that needs you know other kinds of attention like like depression very good questions as well so again because compassion fatigue is not a psychiatric condition whenever we want to do screening for depression and anxiety and that's maybe more for my
85:00 - 85:30 primary care background every single person who comes to me fills out the phq-9 in the GED seven so the pH to nine is a nine question questionnaire that screens for signs and symptoms of depression and the GED seven is a seven generalized anxiety disorder questionnaire so there's nothing wrong with us checking into on our own mental health so checking in whether we do assessments for ourselves just to see where do we score do we need to check with our physician do we need to meet with the counselor because compassion
85:30 - 86:00 fatigue is one thing but you know panic disorder generalized anxiety depression those are other preserve conditions that we need to look at and address and so particularly if we get to that burnout stage where those conditions may have a gun it's not going to be sort of just some strategies to manage compassion to keep that's going to help with that we're actually going to need the ongoing treatment and so whether that looks like medication whether that looks like therapy fond of
86:00 - 86:30 including therapy don't have with what's just to have somebody sort of give us strategies and help us learn how to to manage things in a different way so really important to check in to see is it more than compassion fatigue is it is there a mental health issue that I need to address it's possible that is grief if if we have losses that maybe we haven't worked through and grief not just in the sense of people that we've lost I think that often particularly if
86:30 - 87:00 there are adverse childhood experiences and perhaps because of something that had happened with a parent if there were addictions in the home abuse in the home often we have grief around one of the concepts that I use is less than loved one so less and loved one to someone who by nature of the relationship with us we should love them but because of their own experiences they caused harm to us and so we didn't get the loving relationship that we would have wanted from them so there's often a lot of
87:00 - 87:30 unresolved grief around that so sometimes we need to go in and work through that if we have our own you know experiences of adverse childhood experiences or there's a lot of online quizzes to see you know what do i score in terms of aces and do i need to look at getting you know treatment or support for for that and having an ace score so to speak is not a diagnosis but there there's a strong correlation of higher increase of physical and mental health conditions once we get beyond a certain
87:30 - 88:00 number you know three and four the the numbers start to increase about our chances of having those and so do we need to go in and learn some strategies to to matter some of the impact of that so I mean we're we're human we have histories and we we often need to to check in on those as well right well I so we are out of time is it is 831 so I'm over thank you so much to everyone that asked
88:00 - 88:30 questions and for all of you that provided feedback for Charlene I will definitely share that with her afterwards you can access your certificate of attendance now if you've used 60 minutes or more of the presentation if you wanted to look for the further reading or go back and listen to this again if you wait 24 hours you can log in again and the platform will have saved your progress you can watch parts of it again there downloads of resources so to close the presentation I just have to say a huge thank you to char for this really
88:30 - 89:00 wonderful and really practical presentation I know we're all going to be walking away with some new tools and even me some new advocacy ideas and the audience for your attention and your really thoughtful questions and until next time take care