1. Honoring the Work by Honoring Yourself… Toward a Model of Provider Wellness Helping Helpers to Make a Conscious Practice of Understanding Secondary Trauma and Maximizing Personal Well-Being

2. Welcome / Introductions Ian Danielsen, LCSW, Program Coordinator Greater Richmond SCAN Children’s Advocacy Center Tell us about yourselves o Jurisdiction / Children served o Your community’s child protection network What do you hope to get out of today’s session?

3. Flight Plan for Today An introductory parable Secondary Trauma defined Signs and symptoms Impact on personal and professional lives Compassion satisfaction vs. fatigue Self-assessing satisfaction / secondary trauma Prevention / intervention Self care Developing and implementing agency wellness Final thoughts / Q & A / Adjourn / Be well!

4. An Introductory Parable A grandfather talking to his young grandson tells the boy he has two wolves living inside of him, struggling with each other. The first is the wolf of peace, love and kindness. The other wolf is fear, greed and hatred. “Which wolf will win grandfather?” asks the young boy.

5. An Introductory Parable “Whichever one you feed.” the grandfather replies. - Native American Proverb

6. Secondary Trauma – Also Known As… …Vicarious Trauma …Compassion Fatigue …Burnout

7. Secondary Trauma -- Defined and Illustrated Vicarious trauma is the exposure to another’s traumatic event and the observer’s reactions as a result of that same event. For instance, a client may share something with you that happened to them that was traumatic. What they begin telling you may create an uneasy feeling. Your mind starts to visualize their story.

8. Secondary Trauma -- Defined and Illustrated After your session, you may feel uneasy or upset about hearing your client’s memories. You remind yourself that it is your job to help support your client and “hold” their painful memories. Then you start to wonder, am I safe? You may have thoughts of your visualization pop into your head when you don’t expect it, have nightmares about the experience and question many things. Emotional reactions to such situations can be as vast as experiencing trauma itself.

9. Secondary Trauma -- Defined and Illustrated Emotional reactions to such situations can be as vast as experiencing trauma itself.

10. Signs / Indicators of Secondary Trauma anxiety hypervigilance intrusive imagery flashbacks hyperactivity sleep disturbance rage reactions mood swings loss of interest in outside activities reduced coping ability social withdrawal avoidance behaviors depression / despair hopelessness self-blame, guilt or shame compulsive or aggressive behaviors concentration problems disconnection from others A partial list of things to look for in yourself or others after exposure to a disturbing event, story, communication exchange, media, or news footage include the following:

11. Areas Affected by Vicarious Trauma Cognitive Emotional Behavioral Spiritual Interpersonal Physical Work Performance (Yassen, 1995 & Figley, 1995)

12. Impact on Professional Functioning Performance of Job Tasks Decrease in quality/quantity Low motivation Morale Decrease in confidence Negative attitude Interpersonal Withdraws from co-workers Poor communication Behavioral Absenteeism Exhaustion (Yassen, 1995)

13. Cognitive Schemas Dependency/Trust Safety Power Independence Esteem Intimacy Frame of reference (McCann & Pearlman, 1990)

14. CS-CF Model ( © Beth Hudnall Stamm, 2009) Professional Quality of Life Compassion Satisfaction Compassion Fatigue Burnout Secondary Trauma

15. 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 o Burnout o Secondary Trauma ( © Beth Hudnall Stamm, 2009) www.proQOL.org

16. Easy to Use / Easy to Score The ProQOL is easy to use It can be given individually or in groups It can be given online or at an individual computer Full scoring o More detailed and specific information but takes longer o Better for research or administration The simplified scoring o Less specific but can be completed quickly and can be intuitively understood o Good for training situations ( © Beth Hudnall Stamm, 2009) www.proQOL.org

17. Resiliency Planning Individual, personally o The ProQOL can help you plan where to put your energy to increase our resilience Organizational planning o Can help organizations find ways to maximize the positive aspects and reduce the negative aspects of helping Supportive Supervision o The ProQOL can be used as information for discussions ( © Beth Hudnall Stamm, 2009) www.proQOL.org

18. The ProQOL -- Examples I get satisfaction from being able to [help] people. I feel connected to others. I find it difficult to separate my personal life from my life as a [helper]. I feel worn out because of my work as a [helper]. I have beliefs that sustain me. I believe I can make a difference through my work. I feel "bogged down" by the system. I can't recall important parts of my work with trauma victims. I am happy that I chose to do this work. ( © Beth Hudnall Stamm, 2009) www.proQOL.org

19. Prevention & Intervention Learn about and understand vicarious trauma Talk about it in your agencies Learn coping strategies Identify central schemas Get support Obtain supervision/consultation regarding your work Case consultation for difficult cases Process personal issues (Own personal trauma history – vital to preventing further trauma) Obtain professional counseling (McCann & Pearlman, 1990/Meyers & Cornille, 2002)

20. Prevention & Intervention Respect your personal boundaries Know when to say “no” & remember it is okay to say “no” Utilize humor in safe places Maintain hope and optimism Identify positive components of the work you do Sense of hopefulness about the capacity of human beings to endure, overcome and transform their trauma Have realistic expectations of yourself and your work Engage in legislative advocacy (McCann & Pearlman, 1990/Meyers & Cornille, 2002)

21. Self Care Find your balance Countertransference SandTray, Drawing, written exercise Relaxation & guided imagery Hobbies & Things You Enjoy Relaxation & Guided Imagery exercise

22. From Trauma Stewardship, Laura Vandernoot-Lipsky

23. Developing Wellness Programming Must be a conscious and organized process Consider formation of a wellness committee Agency heads must be prepared to permit use of agency time for wellness activities Think of wellness holistically – mind, body, spirit Examples of agency wellness activities o Monthly wellness newsletter o Recreational / leisure time among agency staff and volunteers o Wellness baskets donated by Board members / others o Access to yoga, massage o Fitness and exercise goal-setting among staff

24. The Starfish Poem There was a young man walking down a deserted beach just before dawn. In the distance he saw a frail old man, he saw him picking up stranded starfish and throwing them back in the sea. The young man gazed in wonder as the old man again and again threw the small starfish from the sand to the water.

25. The Starfish Poem He asked him, “Why do you spend so much energy doing what seems to be a waste of time?” The old man explained that the stranded starfish would die if left in the morning sun. “But there must be thousands of beaches and millions of starfish, “exclaimed the young man, “How can your effort make any difference?”

26. The Starfish Poem The old man looked down at the small starfish in his hand and as he threw it to safety in the sea said.... “It makes a difference to this one.”

27. Film Clip: The Fly http://www.youtube.com/watch?v=ragM3CI0USA What is the film maker’s message(s) here? How does this apply to the work you do with children and families? How can you keep these life lessons fresh? The human mind can radically change itself and not depend on the environment to change it. Please see the importance of this. The environment is created by you, so if you depend on the environment, on the structure of society to change you, then you are deceiving yourself, you are living in an illusion. Because you have created this society. ---- Krishnamurti

28. Additional Resources Secondary Traumatic Stress: A Fact Sheet for Child-Serving Professionals - http://www.nctsn.org/sites/default/files/assets/pdfs/secondary _traumatic_tress.pdf http://www.nctsn.org/sites/default/files/assets/pdfs/secondary _traumatic_tress.pdf - Compassion Fatigue Self Test - http://psychink.com/ti2012/wp- content/uploads/2012/07/207PrewkshpTIstud.2012.pdf http://psychink.com/ti2012/wp- content/uploads/2012/07/207PrewkshpTIstud.2012.pdf - Compassion Fatigue and Vicarious/Secondary Trauama in the Helpin Profession - http://medicinemoves.ca/compassion- fatigue-vicarioussecondary-trauma-helping-profession/http://medicinemoves.ca/compassion- fatigue-vicarioussecondary-trauma-helping-profession/ - Running on Empty: Compassion Fatigue in Health Professionals - http://www.compassionfatigue.org/pages/RunningOnEmpty. pdf http://www.compassionfatigue.org/pages/RunningOnEmpty. pdf

29. Ian Danielsen, LCSW, Program Coordinator GRSCAN Child Advocacy Center 1001 E. Broad St. LL40 Richmond, VA 23223 (804) 643-7226 idanielsen@grscan.com