1. Vicarious Trauma & Compassion Fatigue
Finalized May 31, 2017
Developed by:
Mental Health & Addiction Services, Western Health

2. Compassion Fatigue Vicarious Trauma Burnout
Often, these and many other terms are used interchangeably and there is even disagreement among scholars and practitioners about the definitions and overlap.
We will take some time to separate and define the three concepts, to create a common understanding, for the purpose of this session.
Keep in mind that these may be applied differently in different literature and it is important to determine the definition being used by an author or presenter each time you approach these subjects.
Mathieu, Françoise (2012)

3. Vicarious Trauma (VT)
The stress and trauma workers experience due to empathic engagement with patients and families who are experiencing grief and trauma
Characteristics:
stories we hear are transferred onto us in a way that we are secondarily traumatized and have difficulty ridding ourselves of the images or experiences
fundamental beliefs about the world are altered and possibly damaged by being repeatedly exposed to traumatic material
Normal
Inevitable
Cumulative
The term vicarious trauma was first coined by Pearlman & Saakvitne (1995) to describe the profound shift in world view that occurs in helping professionals when they work with clients who have experienced trauma

5. Compassion Fatigue (CF)
The profound emotional and physical erosion that takes place when helpers are unable to refuel and regenerate after vicariously experiencing the trauma of those they help
Characteristics:
pronounced change in helper’s ability to feel empathy for their patients/clients, loved ones, co-workers
increased cynicism at work
increased anger and irritability
loss of enjoyment of career
Dr. Charles Figley’s description of Compassion Fatigue as the “cost of caring” for others in emotional pain is the most commonly referenced (Figley, 1982)

7. Burnout
Physical & emotional exhaustion as a result of prolonged stress and frustration
Characteristics:
depleted ability to cope with work demands
sense of powerlessness to achieve goals
does not necessarily alter our view of the world, but our view of the workplace
can happen in any occupation
Vicarious trauma and compassion fatigue can lead to burnout but burnout can also happen for other non-traumatic physical and emotional stress within the workplace.

8. ABC’s of Addressing Vicarious Trauma & Preventing Compassion Fatigue
Awareness
Balance
Connection

9. Assess your reactions and your needs
Awareness
Assess your reactions and your needs

10. Activity – Self-Assessment
Handout: Burnout, Compassion Fatigue, and Vicarious Trauma Assessment
* For a one-hour session – the assessment can be completed as a pre-requisite or given as a take-home handout

12. Warning Signs Continuum
Headington Institute Document – Understanding & Addressing Vicarious Trauma (page 18-20) - may be helpful for more warning signs
How am I doing today?
How did my day rate on a scale of 1 – 5?
What are my signs and symptoms?

13. Balance
Take care of your physical health & nurture yourself through mini-escapes and pleasant activities during each day (even a deep breath helps)
Create separation between work and home
Treat yourself with compassion
Transform negative perspectives (challenge your thinking, find meaning)
Develop strategies to support your own needs and emotions when working with others’ trauma
Need to maintain our ability to continue this work.
Consider other professional and personal development on topics such as:
Self-Care
Relaxation
Mindfulness
Work-Life Balance
Assertiveness / Developing Boundaries

15. Practice Self-Compassion
Helpful when experiencing difficult or intense emotions
Three Steps:
Mindfulness — become aware of the emotions you are feeling, label and just notice them
Identify feelings as normal human experience
Treat yourself with loving kindness — be gentle and caring with yourself

16. Practice Extreme Self-care
When you practice extreme self-care and put yourself first, you are then fully available to others without frustration, anger, or resentment
People won’t always like it:
“I will only be checking s twice a day”
“I have to say no because I have made a commitment to myself to reduce my workload”
“Thanks for asking however this doesn’t fit with my current responsibilities (focus / workload / etc.), maybe you could ask…”
“I’ve decided to take better care of myself so I’m not taking on any new projects right now”

17. Protective Activities While Helping
Write notes
Stretch or tense/release specific muscles
Create a separation
Change breathing
Protecting ourselves from trauma content:
To picture or not to picture?
Shields up
Grounding (wiggle your toes, rock in my pocket, drink H2O)

18. Connections Talk out your stress
Process your thoughts and reactions with someone else at work or home
Build a positive network that supports you, not fuels your stress
It is okay to draw back our energy from those we love, when they are draining our capacity to care for ourselves.

19. Organizational Supports
Supportive management:
timely & effective supervision
flexible manager who is open to regular workload assessments in order to reduce trauma exposure and create balance
Debriefing
Critical Incident
Cumulative
Informal - Low-Impact Disclosure
Professional Development
Teamwork
Team Building
Counselling / EAP supports
Model and encourage balance and positive coping techniques
For those working alone:
Develop a peer supervision and debriefing network
Collaborate when possible – share the workload and increase connection (double benefit!)
Professional development cutbacks – try no-cost options – webinars/Ted Talks, reading, peer-led development (share our talents with each other)

20. Low Impact Disclosure (LID) or “Anti-Sliming Strategy”
Formal vs. informal debriefing
Steps:
Increased self-awareness
Fair warning
Consent (Ask what need)
Low impact disclosure
Ask self:
Is the listener aware that I am about to share graphic details and are they able to control the flow?
How much detail do I need to share?

21. Activity – Personal Commitment
Need to maintain our ability to continue this work.

22. Suggested Resources Francoise Mathieu Dr. Gabor Mate
Laura van DerNoot Lipsky
Dr. Jon Kabat-Zinn
Headington Institute