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Vicarious Trauma and Stress Management

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Vicarious Trauma and Stress Management

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    1. Vicarious Trauma and Stress Management Identification and Ethical Intervention Anna M. Whalley, LCSW Shelby County Crime Victims Center 901.545.4357

    2. Primary PTSD Individuals who have experienced, witnessed or were confronted with a traumatic event and responded with intense fear, horror or helplessness.

    3. Post Trauma Responses- Physical Difficulty falling asleep or staying asleep Nightmares Restlessness Headaches Change in appetite Decreased libido

    4. Post Trauma Responses- Emotional Difficulty concentrating or making decisions Grief Moodiness Easily startled Guilt Numbness Depression

    5. Description or Disorder? Labeling a normal reaction? Small percent develop PTSD Small percent develop secondary PTSD Rose Simering, PhD, James Munroe, EdD, Stacy Bird Gulliver, PhD

    6. Secondary Trauma Indirect exposure to trauma through a firsthand account or narrative of a traumatic event.

    7. Why talk about ethics? Impact on clients Impact on practitioner Impact on agency practice Impact on funding/budgeting Impact on clients

    8. Consequences Disruptions in the relationship with the victim Conflict with professional colleagues Violations of boundaries Herman, 1992

    9. Consequences The worker may push victims too quickly in an effort to master their own responses.

    10. Consequences The “silencing response” This will hurt the client or me. This cannot be true. If this happened to you, it could happen to me. Anna Baranowsky, 1997

    11. Possible Ethical Consequences Less than desirable services to victims Staff friction and disruption Poorly thought out program decisions Straying from agency mission

    12. Possible Correlates to Secondary PTSD Personal trauma history Large number of survivors in caseload Insufficient training

    13. Correlates, cont. Identification with victims Insufficient support in the workplace Insufficient social and familial support

    14. Compassion Fatigue “The convergence of post traumatic stress, secondary traumatic stress and cumulative stress/burnout in the lives of helping professionals and other care providers.” Figley, 1995

    15. Compassion Fatigue Intrusive thoughts or images Difficulty separating work from personal life Lowered frustration tolerance/anger outbursts Gentry, Baranowsky and Dunning

    16. Compassion Fatigue Dread of working with certain clients Depression “Assumptive world” disturbances Hypervigilance

    17. Compassion Fatigue Self destructive self-soothing behaviors Diminished sense of purpose with career Decreased functioning in non-work situations Chronic lateness

    18. Compassion Fatigue Frequent headaches Exhaustion Gastrointestinal complaints Increased irritability Lowered self-esteem Workaholism

    19. Chronic Responsibility Syndrome “I can do it better, so I better do it.” “It won’t be done if I don’t do it.” Say “No.” Delegate and Train Take a Sabbatical

    20. Who is at risk? Professionals, family members, friends and associates of trauma survivors Victim assistance specialists, psychologists, social workers, lawyers, disaster workers, nurses, doctors, care givers, clergy

    21. Prevention- The Ethical Course Secondary stress is predictable. Secondary stress is damaging. Secondary stress “rolls uphill.” Mandate to do no avoidable harm

    22. Prevention Professional strategies Balancing caseloads Accessible supervision Pearlman and Saakvitne, 1995

    23. Prevention Organizational Strategies Sufficient release time Safe physical space

    24. Prevention Personal strategies Respecting one’s limits Maintaining time for self care

    25. Prevention General Coping Strategies Self-nurturing activities Seeking connection

    26. Predictors of Effective Trauma Workers Mentally healthy Interact in positive ways with colleagues Flexible and ready for the unexpected Mindful of nonverbal actions Take care of themselves Rosemary Thompson, 2003

    27. Self Awareness and Care- Post Crisis Know your “triggers.” Stay aware of your own issues. Be human and allow yourself to grieve. Maintain realistic expectations about work.

    28. Ask for and accept help from other professionals. Build a healthy support group. Seek the inputs of others who remain healthy. Delegate responsibilities. Remember that you learn from the experience.

    29. Live a healthy , balanced life. Eat good foods. Set and keep healthy work boundaries. Take time to exercise, rest, meditate or pray. Develop and reward your sense of humor. Avoid chaos.

    30. “Don’ts” Don’t make big decisions. Don’t blame others. Don’t spend energy complaining. Don’t try a quick fix.

    31. Ethical Supervision Don’t teach what you don’t know. Admit your limitations. Follow your own guidelines. Follow the Code of Ethics. Remember to remember.

    32. The Road Back Home Sense of well-being, comfort, purpose, identity and empowerment Gentry, Baranowsky and Dunning

    33. Task One Assess and Evaluate Symptoms being experienced by the professional Events of professional and personal life which have contributed to these symptoms

    34. Assess- Personal Past victimization Personal values and attitudes Need for control Personality Residual stress level General health

    35. Assess- Organizational Work overload Threat of funding cuts Job conflicts/confusion Interpersonal conflicts Insufficient resources Supervisor’s attitudes Organizational changes

    36. Task Two Personal and Professional Time-Line Develop a narrative of what brought you to this point Safe place visualization Reconnecting with hope and empowerment

    37. Task Three Reframing and Reprocessing Professional goals Personal goals Primary and secondary trauma Triggers Self-regulation

    38. Task Four Supervising the self Develop the idea of the Great Supervisor Omni-benevolent Omniscient Says only the best Identify needed skills and self soothing areas

    39. Task Five Practice, practice, practice! Remain aware of personal reactions Guide oneself gently back Process reactions with supervisor and/or peers

    40. Celebrate your successes! Remember the 80% rule. Remember the calls that you never get. Remember that your time, skills and care are the greatest gifts you can give.

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