supporting staff in working with families in trauma• investigating a vicious abuse/neglect report...
TRANSCRIPT
Minnesota Association for Children’s Mental Health
(MACMH) 2016
Supporting Staffin working with Families in Trauma
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
What it is Not
• PTSD
• Bad Day
• Inability to see our impact
• Personal issues
• 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
What it is Not, cont.
• Vicarious trauma
• Compassion fatigue
• Secondary trauma
• Secondary victimization
Trauma by any other name…
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• 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
• 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.
Symptoms of STS, cont.
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• 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
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
Resources and References
• National Child Traumatic Stress Network
– www.nctsn.org