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Compassion Fatigue Among Camp Staff: An Exploratory Pilot Study Southeast Therapeutic Recreation Symposium Gatlinburg, T

Compassion Fatigue Among Camp Staff: An Exploratory Pilot Study Southeast Therapeutic Recreation Symposium Gatlinburg, TN May 2013. Angela J. Wozencroft, Ph.D., CTRS Assistant Professor, Therapeutic Recreation (865) 974-1289, awozenc1@utk.edu Steven N. Waller, Ph.D., D.Min ., CPRP, CSPC

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Compassion Fatigue Among Camp Staff: An Exploratory Pilot Study Southeast Therapeutic Recreation Symposium Gatlinburg, T

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  1. Compassion Fatigue Among Camp Staff: An Exploratory Pilot StudySoutheast Therapeutic Recreation SymposiumGatlinburg, TNMay 2013 Angela J. Wozencroft, Ph.D., CTRS Assistant Professor, Therapeutic Recreation (865) 974-1289, awozenc1@utk.edu Steven N. Waller, Ph.D., D.Min., CPRP, CSPC Associate Professor, Recreation & Sport Management (865) 974-1279, swaller2@utk.edu Department of Kinesiology, Recreation, and Sport Studies The University of Tennessee 1914 Andy Holt Ave., HPER 322 Knoxville, TN 37996-2700

  2. Learning Objectives Upon completion of this session each participant will: • Define the term “spirituality” and “compassion fatigue” elaborate on its relationship to their professional lives. • Name factors that contribute to the levels of compassion fatigue and spirituality. • Name three strategies for maintaining spirituality and avoiding compassion fatigue.

  3. Outline • Introduction • Review of Literature and Theoretical Framework • Methods • Results • Discussion • Limitations and Future Research • Conclusion • Group Discussion • Q & A

  4. The purpose of this session will be to: • Examine the relationship between spirituality and compassion satisfaction-fatigue among camp staff. • Ascertain the role that spirituality and compassion satisfaction-fatigue plays in the work life of camp staff. • Explore how compassion satisfaction/fatigue may impact RT professionals.

  5. Purpose & Importance Purpose of the Study: • The purpose of this study is to examine the relationship between the levels of spirituality and compassion fatigue experienced by the student camp staff working with Camp Koinonia 2012. Importance: • Contributes to the existing line of scholarship in the areas of spirituality and leisure and compassion fatigue and RT/TR. • Moreover, this research endeavor draws further attention to an under-researched area within recreation and leisure studies—the spirituality and compassion fatigue of RT practitioners.

  6. BACKGROUND INFORMATION • Camp Koinonia is 3 credit academic course offered in the spring semester. • Over 200 students enroll in the course where they learn about the procedures, philosophy, rights and ethics of working with people with disabilities. • The culminating end of the semester project is implementing the week long residential therapeutic camp where the student become the staff of the camp (activity staff, activity leaders, and counselors) for 150 campers with multiple disabilities. • The primary goal of the course is to provide a “meaningful, experiential learning opportunity for university students while involving children and young adults, some with severe disabilities, in outdoor activities that they would not be able to do otherwise” (The Camp Koinonia, n.d., para. 1). • While the course itself is housed in the TR program, it draws from numerous majors across campus, therefore providing this research with a broad lens to examine college students’ attitudes toward those with disabilities.

  7. Key Terms • Compassion Fatigue (CF): is a condition characterized by a gradual lessening of compassion over time. • Compassion Satisfaction (CS): the pleasure you derive from being able to do your work, namely with helping others. • Burnout: is one negative element of CF. Burnout is associated with gradual feelings of hopelessness and difficulties in dealing with work or in doing your job effectively. Triggers include but are not limited to the feeling that your efforts make no difference; very high workload; or a non-supportive work environment. • Secondary Traumatic Stress (STS): a second negative element of CF. Work related, secondary exposure to extremely stressful events.

  8. Assumptions • This age cohort did not have experience with care giving in this capacity. • Students were not familiar with working with people with disabilities. • This is a generation who is walking away from organized religion, but embracing their “personal” spirituality. • Students may be predisposed to working with those with disabilities/care giving – some intrinsic motivation.

  9. Figure 1. Compassion Satisfaction-Fatigue Model Source: http://www.proqol.org/Full_CS-CF_Model.html

  10. Literature Review: Spirituality • Spirituality permeates the very fabric of American society (Wuthnow, 1988, 2010) • During the last 10 years, in the United States an escalating number of people have indicated they are more “spiritual” than “religious (USA Today, 2008; Pew Forum on Religion & Public Life, 2007, 2010, 2012). • Spirituality is an abstract concept that many scholars have attempted to operationalize (e,g., Benner, 1989; Bruce & Novinson, 1999; Canda & Furman, 1999; Hill & Pargament, 2003; Wuthnow, 1988). • Spirituality is defined in a variety of ways including: • “ … a force or life energy that extends further than oneself and is often connected to religions “(Hunter, 1990). • “… a sense of interconnectedness with those surrounding him/her along with an aspiration to create meaning while embracing views on what is good and wrong” (Kurian, 2005). • Moreover, our sense of spirituality carries over into multiple domains of our lives, including our work and professions (deKlerk, 2005; Kinjerski & Skrypnek, 2004).

  11. Literature Review: Compassion Fatigue • Compassion is a complex emotion that allows caregivers to hold and sustain themselves in emotional balance while holding patients’ despair in one hand and their hopefulness in the other. Compassion requires an inner conviction and resiliency—a passion of personal ethics, personal beliefs, and a personal way of being. (Lewin, 1996). • The term “compassion fatigue” was first used by Joinson (1992) to illustrate the unique stressors that affect people in caregiving professions (i.e., nurses, counselors, clergypersons). • The majority of studies regarding compassion fatigue have been in the area of nursing and have focused on distinguishing between compassion fatigue and job burnout (Joinson, 1992; Jacobsen; Bush, 2009). • To date, there is a gap in scholarship that examines compassion fatigue among recreation therapists.

  12. Research Questions Based on the conceptual framework and review of literature, the following research questions were developed: 1. Is there an association between spirituality and CF among camp staff? 2. Are there differences in both spirituality and CF scores when demographic variables (e.g., gender, race, class standing) are considered?

  13. Methods • Following the completion of Camp Koinonia 2012, 210 student volunteer participants were asked to take part in an on-line survey (61 items) which contained three sections: • Section 1: Compassion Satisfaction and Compassion Fatigue Scale (30 items7-point Likert-type scale (1= Never”; 5= “Very Often”); 3 subscales: Compassion Satisfaction-10; Burnout-10; Secondary Trauma-10) • Section II: Spiritual Involvement and Beliefs Scale(SIBS-R; 22 items; 7-point Likert-type scale (1= “Strongly Disagree”; 7= “Strongly Agree”); 4 subscales: Core Spirtality-16; Spiritual Perspective/Existential-5; Personal Application/Humility-2; Acceptance/Insight-1) • Section III:Demographic Information (9 items) • Descriptive statistics, including frequencies and percentages, were calculated to assess demographic characteristics of the sample. T-test and one way ANOVA, and regression analysis were utilized to examine the research questions.

  14. Results: Sample Profile (N=108) • Response Rate: 51% • 27 females (25%) and 81 males (75%). • The largest percentage (53.7%) of participants indicated they were in the 19-21 years of age. Mean age was 21.72. • The majority of the sample was Caucasian (97.2%). • Over half of the participants (58.3%)were in their senior year of study • A large number of respondents (66.7%) indicated they were studying something other than TR/RT. • The majority of the participants (75.9%) job role was that of counselor. • Just under half of the respondents (46.3%) reported spending 1-5 hours providing direct care.

  15. Table 1. Sample Profile

  16. Table 2. Descriptives- CF Scale

  17. Results: Statistical Analysis • Differences in Spirituality and Compassion Fatigue: • The data were analyzed utilizing t-test (gender and age) and one way ANOVA (educational level, academic major, and job title/role) to determine if there were differences between groups along demographic categories and spirituality and compassion fatigue scores. • Compassion Satisfaction-Fatigue: • Significant differences were found between gender, t(107)=29.81, p=.000; age, t(107)=29.81, p=.000); and academic major, t(107)=36.57, p=.000. • Spirituality: • Significant differences were found between gender, t(107)=62.60, p=.000; age, t=(107)=62.60, p=.000; academic major, t(107)=63.300, p=.000. • Relationship Between Compassion Satisfaction-Fatigue and Spirituality • Slightly negative correlation between CSF and Spirituality (r=-012)

  18. Table 4. Highest and Lowest Mean Scores SIBS-R

  19. Table 5. Highest and Lowest Mean Scores Compassion Satisfaction-Fatigue Scale

  20. Discussion Research Question 1: Is there an association between spirituality and compassion fatigue among camp staff? a. There is a very weak, negative association between spirituality and compassion satisfaction-fatigue. Correlation is statistically insignificant. b. This maybe attributed to the split between those in the sample that embrace spirituality and those that are self-reliant. Research Question 2: Are there differences in both spirituality and compassion fatigue scores when demographic variables are considered? • Yes there were differences on certain variables, gender, age, academic major. • The mean scores on the SIBS-R suggests that many in the sample appears to be self-reliant, thus depends relatively little on spirituality. • Findings are consistent with other studies: (1) women are more spiritual than men (Barna 2011; Pew Forum on Religion & Public Life, 2007, 2010, 2012; Rich II, 2012); (2) educational attainment (Bryant, 2007); (3) age (Moberg, 2005; Olson, 2009).

  21. Discussion Research Question 3: What factors contribute to the levels of CF and spirituality of camp staff? • CF • Low levels of CF in sample • Majority of sample (59.3%) in the high range on CS subscale, average on burnout subscale (100.0%), and low on STS (82.4%). • Education, co-worker support and collegiality may have contributed to low levels of CF (Conrad & Kellar-Guenther, 2006). • Spirituality • Positives • Moderately spiritual: SIBS-R Q.22: How spiritual a person do you consider yourself? (1=Not spiritual, 7=Very spiritual; M=3.19, SD=1.50) • Recognition of a Higher Power in the universe; active spiritual life; introspection; recognition of the importance of spirituality; focus on their own spiritual development and being in relationship with the High Power. • Negatives • Very little suffering; little emphasis on spiritual reflection; very little experience with transformative spiritual experiences. Combined these factors may negatively impact compassion.

  22. Limitations • The manner in which the respondents may have interpreted the term “spirituality.” • The SIBS-R despite its reliability and validity does not segment items that assess religiosity and spirituality as two independent concepts with relevant constructs. Better tools to assessment spirituality (e.g.) DUREL; Spiritual Assessment Inventory) • The number of usable cases in the sample due to “timed out” cases (n=102). • Timing of the data collection/online survey distribution

  23. Future Research • Further explore the concept of “spirituality” and CF and what it means to RT professionals. • Examine CF in other caregivers such as parents’ of children with disabilities. • Further conceptualization of the concept of CF by expanding existing models may also heighten our understanding of the role that spirituality and CF plays in the personal and professional lives of RTs.

  24. Conclusion • Low levels of CF is an important factor in providing quality services to people with disabilities. • High levels of CS coupled with the belief in a Higher Power may be important mitigators in lowering CF and burnout. • Staff training prior to the start of a major initiative like Camp Koinonia helps to lower CF.

  25. Question/Discussion • How do you define spirituality and compassion fatigue? • What role do you feel each plays in your career? • How do these influence the RT process?

  26. Select References Bourassa, D. (2012). Examining self-protection measures guarding adult protective services social workers against compassion fatigue. Journal of Interpersonal Violence, 27(9), 1699-1715. Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63-70. Bride, B., Radey, M., & Figley, C. (2007). Measuring compassion fatigue. Clinical Social Work Journal. (35), 155-163. Bisesi, M., & Lidman, R. (2009). Compassion and power: Religion, spirituality, and public administration. International Journal of Public Administration, 32(1), 4- 23. Bruce, W. M. (2000). Public administrator attitudes about spirituality: An exploratory study. The American Review of Public Administration, 30(4), 460-472. Bruce, W. & Novinson, J. (1999). Spirituality in public service: A dialogue. Public Administration Review, 59(2), 163-169. Conrad, D. & Kellar-Guenther, Y. (2006). Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers. Child Abuse & Neglect, 30, 1071-1080. Craig, C. D., & Sprang, G. (2010). Compassion satisfaction, compassion fatigue, and burnout in a national sample of trauma treatment therapists. [Article]. Anxiety, Stress & Coping, 23(3), 319-339. doi: 10.1080/10615800903085818

  27. Select References Hayes, M. J. (2009). Compassion Fatigue in the Military Caregiver. Retrieved from http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA498593 McSherry, W. (2006). The principal components model: a model for advancing spirituality and spiritual care within nursing and health care practice. Journal of Clinical Nursing, 15(7), 905-917. ProQol v. 5.0. Compassion Satisfaction-Compassion Fatigue Full Model. Retrieved from http://www.proqol.org/Full_CS-CF_Model.html. Sprang, G., Clark, J., & Whitt-Woosley, A. (2007). Compassion fatigue, compassion satisfaction and burnout: Factors impacting a professionals quality of life. Journal of loss and trauma, (12), 259-280. Showalter, S. (2010). Compassion fatigue: What is it? why does it matter? Recognizing the symptoms, acknowledging the impact, developing the tools to prevent compassion fatigue and strengthen the professional already suffering from the effects. American Journal of Hospice & Palliative Medicine, 27(4), 239-242.

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