Resilience: The Science of Hope | 2018 Ann Gaasch, Executive Director Supporting Staff In Working With Families in Trauma Resilience: The Science of Hope | 2018 Ann Gaasch, Executive Director

“At the start of my career - not just Me Too, which is not the totality of my career - I wish I would have known that you don’t have to sacrifice everything for a cause. And that self-care and self-preservation is also a tool that is necessary to do the work. It doesn’t make you more loyal to the cause or down for the movement if you sacrifice parts of yourself that you don’t want to.” - Tarana Burke

Learning Objectives Participants will: Identify the different stress disorders associated with working in families with trauma histories; Distinguish burnout and secondary traumatic stress; and Practice strategies associated with preventing stress

Introductions Small Group Exercise

Choose one scenario One of the staff members from your team comes in your office to hear if you have heard the news. One of the youth you have worked with has been arrested for assault. One of your staff members is at their limit. They have reached out several times to the family about the learning difficulties of the child, but the mom is unresponsive. The child is acting out, and they think it is when the mom’s boyfriend stays over. They have called Child Protection, but nothing has happened.

With your partner, answer the following questions: What policies and procedures does your agency have in place to deal with this scenario? Who would you call first? What support can you offer the team? What do you do for yourself?

What Secondary Stress is not: PTSD Bad Day Inability to see our impact Personal issues

What it is Not, cont. Secondary trauma is not burnout. Burnout is caused by increased workload and institutional stress Happens over time Time off or a change can remove or reduce it

Trauma by any other name… Vicarious trauma Compassion fatigue Secondary trauma Secondary victimization STS is presence of PTSD symptoms caused by at least one indirect exposure to traumatic material. Vicarious trauma focuses less on trauma symptoms and more on the covert cognitive changes that occur following cumulative exposure to another person’s traumatic material. The primary symptoms of vicarious trauma are disturbances in the professional’s cognitive frame of reference in the areas of trust, safety, control, esteem, and intimacy

What is Secondary Traumatic Stress? Exposed indirectly to trauma through hearing about the firsthand trauma experiences of others A cumulative response to working with many trauma survivors over an extended period of time, Or it may result from reactions to a particular client’s traumatic experience.

Causes of Secondary Traumatic Stress Facing the death of a child or adult family member on the worker’s caseload Investigating a vicious abuse/neglect report Frequent/chronic exposure to emotional and detailed accounts by children of traumatic events Photographic images of horrific injuries or scenes of a recent serious injury or death Continuing work with families in which serious maltreatment, domestic violence, or sexual abuse is occurring Helping support grieving family members following a child abuse death, including siblings of a deceased child.

Causes of Secondary Traumatic Stress, cont. Exposed to traumatic or life threatening events of their own Intense verbal or physical assault by clients or community members

STS is exacerbated by: Feelings of professional isolation, Frequent contact with traumatized people Severity of the traumatic material direct contact with victims, exposure to graphic accounts, stories, photos, and things associated with extremely stressful events. Dealing with the pain of children

Symptoms of STS Inability to face complexity Avoidance of clients, inability to listen to clients Increased fatigue or illness, Social withdrawal, Reduced productivity, Feelings of hopelessness, Despair

Symptoms of STS, cont. Nightmares, Feelings of re-experiencing of the event, having unwanted thoughts or images of traumatic events, Anxiety, Excess vigilance, Avoidance of people or activities, or Persistent anger and sadness

Symptoms of STS, cont. Changes in feelings of safety, Increased cynicism, and Disconnection from coworkers and/or loved ones Managing boundaries, Dealing with their emotions Have anxiety for their own children and irritability toward their colleagues and family.

How STS Affects Workplace Higher rates of physical illness, Great absenteeism, Higher turnover, Lower morale, and Lower productivity.

Risk Factors High caseload demands, A personal history of trauma, Limited access to supervision, Lack of a supportive work environment, and/or Lack of a supportive social network.

Prevention through Professional Strategies Psychoeducation, Balanced caseloads, Accessible supervision, Planned assignment rotation, Access to peers, Continuing education, Access to new information

Prevention through Agency Strategies, cont. Sufficient leave time, Safe physical space, Good supervision, Destigmatize trauma reactions through organizational recognition or acknowledgement, Promotes timely mental health support, and Access to employee assistance program

Mental Health Days What are they? What are the pitfalls? How can they be used effectively?

Prevention through Trauma-Informed Supervision Safety Trust and Transparency Collaboration and Mutuality Empowerment Voice and Choice

Prevention through Trauma-Informed Supervision, cont. Recognition of trauma diagnoses, symptoms and triggers (professionals trying to avoid re-experiencing their own emotions) Recognition of re-traumatizing cultural practices Behavior understood as adaptive coping

Things to watch out for… Problems and symptoms are synonymous Over emphasis on policies and rules Absence of symptoms is primary goal Safety and trust is taken for granted Respond personally to others’ emotions

Prevention through Personal Strategies Respecting your limits, Taking time for self-care, Teaming, Venting v. Fomenting, and Be wary of volunteering in a similar type of work

Personal Strategies

Reflective Supervision Stepping back from work Emotional content of the work Professional’s responses as they affect interactions with clients Safety, calmness, and support Learning environment Not therapy

Protective factors Self-nurturing Seeking connection Social support network Outside interests

Interventions Strategies to evaluate secondary stress Cognitive behavioral interventions Mindfulness training Reflective supervision Caseload adjustment Informal gatherings following crisis events (to allow for voluntary, spontaneous discussions) Change in job assignment or work group Referrals to Employee Assistance Programs or outside agencies

Your Self Care Plan Evaluate your coping strategies. What works for you? What do you do that isn’t working so well? What are the barriers to self-care?

Your Self Care Plan Domains of self care: physical, emotional, spiritual, professional, social, financial, psychological

Your Self Care Plan What do you already do? What two things do you want to try to add to your self-care practice?

Your Self Care Plan Emergency Self Care Relaxation Self-Talk Social Support Mood Resilience

Your Self Care Plan My Daily Self Care Plan Body, Mind, Spirit, Emotions, Relationship, Work My Top Three Positive Coping Strategies My Emergency Self Care Plan What helps What should I avoid? https://www.ucalgary.ca/wellbeing/files/wellbeing/self-care-starter-kit.pdf

Resources and References National Child Traumatic Stress Network NCTSN.org

Contact Information Ann Gaasch AGaasch@FamilyWiseServices.org Twitter: @AnnGaasch LinkedIn.com/in/AnnGaasch