1. Barbara Moser, MD WISE Advisory Board Barbara@preventsuicidemke.com
Building Our Compassion Resilience 3rd Bienniel Youth Services Conference: Building a Framework for Youth May 2, 2017
Barbara Moser, MD
WISE Advisory Board

2. Building Our Compassion Resilience
Intended Topics for Our Conversation:
Understanding of the language used
One way to look at professional compassion
Losing and rebuilding compassion, for others and ourselves
Building Compassion Resilience for ourselves, and the youth we serve

3. In YOUR Work Recently---

4. Vocabulary Compassion Satisfaction Compassion Fatigue Burnout
Positive aspects of working as a helper
Compassion Fatigue
Negative aspects of working as a helper
Burnout
Inefficacy and feeling overwhelmed
Work-related traumatic stress
Primary traumatic stress direct target of event
Secondary traumatic exposure to event due to a relationship with the primary person

5. CS-CF Model Professional Quality of Life Compassion Satisfaction
Compassion Fatigue
Burnout
Secondary Trauma
Professional Quality of Life relates to the balance of compassion satisfaction (good stuff) and compassion fatigue( Bad stuff)

6. Compassion Satisfaction
The positive aspects of helping
Pleasure and satisfaction derived from working in helping, care giving systems
May be related to
Providing care
To the system
Work with colleagues
Beliefs about self
Altruism
Ability to receive gratification from caregiving

7. Compassion Fatigue The negative aspects of helping
The negative aspects of working in helping systems may be related to
Providing care
To the system
Work with colleagues
Beliefs about self
Burnout
Work-related trauma

8. Burnout and Secondary Traumatic Stress (STS): Co-Travelers
Work-related hopelessness and feelings of inefficacy
STS
Work-related secondary exposure to extremely or traumatically stressful events
Both share negative affect
Burnout is about being worn out
STS is about being afraid
Inefficacy with either dealing with work, or doing one’s job effectively
© Beth Hudnall Stamm, Professional Quality of Life Scale (ProQOL). This test may be freely copied as long as (a) author is credited, (b) no changes are made without author authorization, and (c) it is not sold.

9. Complex Relationships
Professional Quality of Life
Compassion Fatigue
Compassion Satisfaction (ProQOL CS)
Work Environment
Client Environment
Personal Environment
Traumatized by work
Secondary Exposure (ProQOL STS)
Primary Exposure
Frustration Anger
Exhaustion
Depressed by Work Environment
(ProQOL Burnout)

10. Helpers Bring Their Own “Stuff”
Helpers include people with all types of education, training and income
Some helpers bring with them histories of difficult lives that may include trauma
Some helpers have difficult family, economic, or other personal situations

11. Measuring CS & CF: The Professional Quality of Life Scale (ProQOL)
The ProQOL is free
A 30 item self report measure of the positive and negative aspects of caring
The ProQOL measures Compassion Satisfaction and Compassion Fatigue
Compassion Fatigue has two subscales
Burnout
Secondary Trauma

12. Not a Medical Test
Helps understand the positive and negative aspects of helping
Not a “psychological test”
Not a “medical test”
Can be viewed as a screening for stress-related health problems

13. For More Information:

14. Compassion Fatigue Awareness project
In addition to the PROQOL, look at these additional measures:
LIFE STRESS TEST
EMPATH TEST

15. What do we believe about human behavior?

16. How do you think about behavior?
A matter of motivation OR
A matter of ability and supports

17. Kids/parents/adults do well if they want to …
Manipulative
Just wants attention
Not motivated
Doesn’t care
Kids/parents/adults do well if they can …
Coping in the way they know how
Lack skills required
Something in their way
Together we can figure it out
There are two very different mindsets on this slide.
Below them are words that we might hear used to describe a child’s behavior or motivation. The first four fit with the belief that kids would do well if they just wanted to. The last four fit with the belief that kids would do well if they could.

18. Compassion Fatigue: a barrier to our effectiveness and happiness
Gradual lessening of compassion over time
Avoid trying to understand what people face
Perspective shifts from “people do well if they can” > “people do well if they want to” 18

19. Compassion Fatigue’s Path
Leave Profession
Zealot
Compassion Resilience
Renewal vs Pathology
Irritability
Withdrawal
Zombie

20. How does compassion fatigue show up?
In you?
Where do you see it in your organization?
What population or with whom are you most challenged to approach with compassion?
What is your physical experience of compassion fatigue?

21. Resiliency Planning Individual, personally Organizational planning
The ProQOL can help you plan where to put your energy to increase our resilience
Organizational planning
Can help organizations find ways to maximize the positive aspects and reduce the negative aspects of helping
Supportive Supervision
The ProQOL can be used as information for discussions

22. Building Our Compassion Resilience
The power to return to a position of empathy, strength, and hope after the daily witnessing of the challenges people face in our community.

23. Building Compassion Resiliency!
Expose yourself to recovery/resilience
Compassionate boundaries - understand your role and your limitations
Connect with colleagues and others in the community
Self-care, including
Self-Compassion

24. Compassionate Boundaries

25. Five Tips for Setting Compassionate Boundaries
1. Know what you want to say “Yes” to in your life (values and priorities).
2. Just say it! Don’t make them guess. Reinforce by pointing out the violations or near violations IN THE MOMENT.
3. Have “meetings” to discuss boundaries. Structure offers safety for both sides.
4. Give explanations that are specific, relevant to the other person, and offer shared solutions.
5. Plan your offense and defense to match your values.

26. Care for Self Balance Social Physical Spiritual Intellectual Emotional
Creative

27. Mindful Self-Compassion
Kristin Neff:
Chhttp://self-compassion.org/ttpmpassion.org/
Christopher Germer:
Basic Principles
Self-Compassion Break

28. Out of Balance? Your first clue Physical Emotional Avoid
New perspective
Adjust lifestyle
Listen to the clues your body and emotions send you.
If we can pick up on the clues our body sends us, we can use the mind/body connection to control the stress reaction. (Ask audience for example of a physical clue they experience that tells them they are stressed. An emotional clue?)
I would like to propose 3 different management options that may be used once you begin to feel yourself “stressing out.” (or if you anticipate a stressful event.)
1. How could you avoid the situation?
If you know the stressful situations, then when possible, don’t put yourself there. Of course, we all realize that this is not always the most practical answer.
2. Another way of thinking about the situation?
If imagination drives human fears as we saw in the modern day fight or flight stress response to imagined lack of control, then why not let your imagination drive your sense of wellbeing?
3. What changes in your lifestyle could help the make the situation less stressful? The rest of this program will present ideas for how we might intervene to deal with stress when we are in the midst of it as well as how making decisions according to our life priorities can help us to to be proactive so we can avoid it in the first place.

29. The Bigger Picture My compassion resilience Do I model resilience?
How do I engage my youth?

30. Reflective Questions
What is my belief about the potential for positive outcomes for youth facing our community’s challenges?
What level of hope do I project in my conversations with children, families and my peers?

31. Dr. K. Ginsberg’s 7 C’s of Resilience
Confidence
Connection
Competence
Character
Contribution
Coping
Control

32. Avoidance, anger and apathy
“If I really wanted to do something, I would be able to.”
self esteem
I am not good.
sense of efficacy
I am not able.
Avoidance, anger and apathy
So, why try!
Feelings of Shame

33. Interactions in Context of Trauma
Prefrontal Lobes
Rational thoughts
What can I learn from this?
Limbic
Emotions
Am I loved?
Brain Stem
Survival instinct
Am I safe?

34. What Does Trauma Look Like?
Sensitive to noise
Avoid touch
Heightened startle reflex
Demand lots of attention
Perfectionism
Aggression/Defiance
Confused - What is dangerous? Who can help?
Resist separation from familiar people and safe places
Reactive and impulsive

35. Possible Perspectives of People Impacted by Trauma:
Basic mistrust of adults/ inability to depend on others
Belief that the world is an unsafe place/ bad things will happen and they are usually my fault
Assumption that others will not like them
Fear and pessimism about future
Feelings of hopelessness and lack of control 35

36. We can interrupt the cycle!
The Cycle of Trauma
We can interrupt the cycle! 36

37. How do you think about your behavior?
A matter of motivation OR
A matter of ability and supports

38. Reversing Shame and Blame I care for myself & others
When I am Known, Included and Supported
I am able ✗
I am good
Compassion fatigue
I care for myself & others

39. BUILDING
COMPASSION
RESILIENCE!

40. Reflection

41. Thank-you for the relationships you build and the strategies you implement that improve the present and future lives of children, adults, parents and staff.
WISE Wisconsin.org
Resilience clips at:
RogersInHealth.org