SECONDARY TRAUMA SIGNS, SYPTOMS, SUPPORTS Ohio Primary Parent Advisory Council Ohio Family Care Association 1151 Bethel Rd, Suite 104B Columbus, Ohio Phone: OFCA (6322) The Voice of Ohio’s Foster, Adoptive, Kinship & Respite Resource Families

COMPASSION FATIGUE A physical, emotional and spiritual fatigue or exhaustion that takes over a person and causes decline in his/her ability to experience joy or to feel and care for others. Synonymous with secondary traumatic stress syndrome, vicarious trauma (Figley, 1995; Friedman, 2002)

COMPASSION FATIGUE The prolonged occurrence of the natural behaviors and emotions that arise from knowing about a traumatizing event experienced by another. It’s this constant outputting of compassion and caring over time that can lead to these feelings of total exhaustion. (Figley, 1995; Friedman, 2002)

COMPASSION FATIGUE A one-way street in which individuals are giving out a great deal of energy and compassion to others over a period of time, yet aren’t able to get enough personal support to reassure themselves that the world is a hopeful place. (Figley, 1995; Friedman, 2002)

BURNOUT VS. SECONDARY TRAUMA A seven year, 5 state study of 600+ child welfare professionals concluded that over 50% had symptoms of secondary trauma and reported feeling trapped and hopeless about their work with clients, being in danger while working with clients, and avoiding thoughts and feelings about their clients. Key indicators of higher secondary trauma symptom scores were younger professionals, those with less experience and those who had experienced trauma as a child.

Burnout: Generally occurs over time Often related to feelings that a job’s perceived or actual demands are not supported by the employee’s sense of reward Possibly manifest symptoms that are fairly consistent and prevalent day to day (e.g. irritability, apathy, tardiness. lack of attention to detail) Can be alleviated by change in duties, change in career, increase in rewards, etc. Secondary Trauma: May occur over time or quickly Often tied to exposure to specific events or experiences that are viewed as horrific Possibly manifest symptoms that are inconsistent and extremes in responses associated with triggers that may or may not be anticipated Cannot be alleviated by a job/role change but can be helped in a variety of other ways BURNOUT VS. SECONDARY TRAUMA Secondary Traumatic Stress and the Child Welfare Professional; Pryce, Shackelford, & Pryce (2007)

POST-TRAUMATIC STRESS DISORDER A. RECURRING INTRUSIVE RECOLLECTION OF THE TRAUMA: Intrusive thoughts. dreams. flashbacks. 'dissociative' events. intense emotional and physiological distress when re-exposed to trauma associated stimuli All rights reserved© 1999 Bruce D. Perry

POST-TRAUMATIC STRESS DISORDER B. AVOIDANCE OF TRAUMA - ASSOCIATED STIMULI OR ‘NUMBING’: Sense of detachment. restricted range of affect‘ dysphonia. loss of recently acquired developmental skill. sense of a foreshortened future All rights reserved© 1999 Bruce D. Perry

POST-TRAUMATIC STRESS DISORDER C. PERSISTENT PHYSIOLOGICAL HYPERAROUSAL Sleep difficulties. hypervigilance, difficulty concentrating, increased startle response liability, impulsivity, irritability, physiological hyperreactivity All rights reserved© 1999 Bruce D. Perry

POST-TRAUMATIC STRESS DISORDER The symptoms developed by persons suffering from PTSD or Secondary Trauma are nearly identical. The only difference is that, with Secondary Trauma, the traumatizing event experienced by one person becomes a traumatizing event for the second person. Copyright 2002, childtraumaacademy.com

SYMPTOMS OF SECONDARY TRAUMA Experts in secondary trauma advocate using an employer administered tool or self- assessment tool annually or more often to identify warning signs for secondary trauma. There is great value in creating safety and trust around the exercise of acknowledging and discussing this important issue. Please See Attached Assessment Tools

Examples of Compassion Fatigue/Burnout Symptoms Areas of Personal and Professional Function CognitiveEmotionalBehavioralSpiritual Personal Relationships Physical/ Somatic Work Performance Lowered concentration PowerlessnessImpatientQuestioning the meaning of life WithdrawalShockLow morale Decreased self-esteem AnxietyIrritableLoss of purposeDecreased interest in intimacy or sex SweatingLow motivation ApathyGuiltWithdrawnLack of self-satisfaction MistrustRapid heartbeatAvoiding tasks RigidityAnger/rageMoodyPervasive hopelessness Isolation from others Breathing difficulties Obsession about details DisorientationSurvivor guiltRegressionAnger at GodOver protection as a parent Aches and pains Apathy PerfectionismShutdownSleep disturbance Questioning of prior religious beliefs Projection of anger or blame DizzinessNegativity MinimizationNumbnessNightmaresLoss of faith in a higher power IntoleranceIncreased number and intensity of medical maladies Lack of appreciation Preoccupation with trauma FearAppetite changes Greater skepticism about religion LonelinessOther somatic complaints Detachment Thoughts of self-harm or harm to others HelplessnessHyper-vigilanceIncreased interpersonal conflicts Impaired immune system Poor work comm. SadnessElevated startle response Staff conflicts DepressionAccident proneness Absenteeism Emotional roller coaster Losing thingsExhaustion DepletedIrritability Withdrawal from colleagues Overly sensitive Figley, C., Figley, K.R., Crisis Y2K (2002): The Green Cross Project., Camden, Maine, copyright Please See Table 1.1

SYMPTOMS OF SECONDARY TRAUMA How does confidentiality impact caregiver and worker ability to seek support? What role do labels and humor play in coping with the stress of this work? Mom is a “frequent flyer.” Mom was regularly raped as a child and tends to choose abusive partners. “Baby Daddy” is a “druggy.” The father was raised in and out of residential treatment with no strong positive father figure.

THE BIG PICTURE This is a beautiful picture everything is as it should be... Right?

MAKING A PERSONAL COMMITMENT TO ONESELF AND ONE’S WORK WHY? Because I hurt Because I matter Because my clients matter Because the work I do matters Because the profession matters Because I must

MAKING A PERSONAL COMMITMENT TO ONESELF AND ONE’S WORK HOW? Not alone; get a buddy or a group One day at a time; positive outlets Do something in each realm One change at a time; be realistic Increase mindfulness and acceptance Make time/space for what you love to do Don’t forget and don’t give up Anticipate obstacles; prevention plan

NEXT STEPS In my personal life my next step is: In my professional life my next step is: In my organization my next step is: