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Recognize the ways that serving vulnerable populations experiencing crisis can increase risk factors for compassion fatigue. Increase awareness of how to
assess the impact of compassion fatigue at both the individual and organizational level. Identify strategies to reduce
organizational risk factors and enhance personal and systemic resilience. 3
What brought you to this work?What messages do you tell yourself or
have you heard about what it means to do this kind of work?
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“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.”- Dr. Rachel Remen
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Stress Traumatic stress Post Traumatic Stress
Disorder Burnout Emotional laborCompassion fatigue Vicarious trauma
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WHAT CAUSES STRESS TO
BE MORE IMPACTFUL?
Duration The work is never done In human services, may feel like we’re
working against systems
Uncertainty To what degree can you predict what
will happen today?Uncertainty about basic safety of others
Importance What is the potential impact of your
work? For us, our work affects human lives The people we serve become very
important to us, and their stressors are important to us as well
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Exhaustion – common in many workplaces
Guilt/shame – more amplified in human services; high stakes work
Cynicism/callousness – hardness, lack of empathy/compassion
Crisis – health, relationships, functioning
4 Stages of Burnout 10
The emotional residue of exposure that counselors have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured. Impact of exposure to traumatic
disclosures. Different from burnout Vicarious trauma can occur at any
time, or in one session Burnout is a risk factor for
vicarious trauma and vice versa
https://www.counseling.org/docs/trauma-disaster/fact-sheet-9---vicarious-trauma.pdf11
Work Related Trauma Exposure = Vicarious Trauma
Negative• Vicarious Traumatization• Secondary Traumatic Stress• Compassion Fatigue
Neutral• Impact Managed
Effectively
Positive• Vicarious Resilience• Vicarious Transformation• Compassion Satisfaction
Change in World View Spectrum of Responses
Vicarious Trauma Toolkit
“…the transformation or change in a helper’s inner experience as a result of responsibility for and empathic engagement with traumatized clients.” (Saakvitne et al. 2000)
Vicarious Trauma Toolkit13
“Evaluating our response to trauma exposure is critical, because how we are impacted by our work in the present directly affects our work in the future.”
(van Dernoot, Lipsky & Burk, 2009) 14
Re-experiencing Memories, intrusive thoughts; dreams,
nightmares Avoidance Efforts to avoid/disconnect from thoughts
and feelings; diminished interest in activities; detachment and isolation from others; dissociation/depersonalization
Negative change in mood and thoughts Exaggerated negative beliefs about
self/others; feelings of guilt/shameChange in arousal and reactivity
Hypervigilance; irritability, aggressive outbursts; exaggerated startle response; difficulty concentrating 15
(van Dernoot Lipsky and Burk, 2009)
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ORGANIZATIONAL SYMPTOMS OF
COMPASSION FATIGUE
High absenteeismConstant changes in co-workers relationships Inability for teams to work well together Staff challenges organizational rules and
regulations Aggressive behaviors among staff Inability of staff to complete assignments and
tasks Inability of staff to respect and meet deadlines Lack of flexibility among staff members Strong reluctance to change Inability of staff to trust that improvement is
possible Lack of vision for the futurehttps://www.compassionfatigue.org/organizations.
html; Vicarious Trauma Toolkit ; Adapted from J. Yassen in Figley, 1995
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Identify your own signs of trauma exposure: Thoughts Feelings Behaviors Self-talkRelationships
What are you most likely to notice?What might others observe?What are you least likely to notice?
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Professional Quality of Life Scale (ProQOL) Vicarious Trauma-Organizational Readiness
Guide (VT-ORG) for Victim Services Leadership and missionManagement and supervision Employee empowerment and work
environment Training and professional development Staff health and wellness
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…the work is challenging and rewarding.
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Widespread illness and deathUnemployment and financial
instabilityMental health concerns Social isolationConflict of consciousness
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Dramatic changes to “business as usual” with little notice
Transition to teletherapy
Concerns about the health and well-being of individuals served
Loss of separation between work and home
All the unknowns
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WHAT’S THE IMPACT?
People are exhaustedReduced access to work-based
supportsRestrictions on self-care activities
and resourcesWorkplaces are organized
around safety, not values
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DEVELOPING STRATEGIES FOR MANAGING COMPASSION FATIGUE
Personal Self-care Identity outside of work
Professional Peer supportGrowth mindset Building a network of resources
OrganizationalQuality supervision Professional development Policies and procedures
Community Trauma-informed systems Access to resources
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(van Dernoot Lipsky & Burk, 2009) 25
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Vicarious trauma is anoccupational challenge for those working with trauma survivors.
Organizations have an ethical mandate of a “duty to train,”wherein workers are taught about the potential negative effects of the work and how to cope.
Vicarious Trauma Toolkit; Munroe, J. F., in Figley, Compassion Fatigue, 199528
Vicarious trauma (VT) is an occupational challenge for the fields of
victim services, emergency medical services, fire services, law enforcement,
and others. Working with victims of violence and trauma has been shown to
change the worldview of responders and can also put individuals and
organizations at risk for a range of negative consequences.
A vicarious trauma-informed organization recognizes these challenges and assumes the responsibility for proactively
addressing the impact of vicarious trauma through
policies, procedures, practices, and programs.
Vicarious Trauma Toolkit29
Leadership and Mission Effective leadership, clarity, and alignment with
mission
Management and SupervisionClear, respectful, quality, inclusive of VT
Employee Empowerment and Work Environment Promotes peer support, team effectiveness
Training and Professional Development Adequate, ongoing, inclusive of VT
Staff Health and WellnessDevotes priority and resources to sustaining
practices Vicarious Trauma Toolkit; VT-ORG30
Be present, literally
Assess your own level of compassion fatigue
Check in with staff, providing a “holding” space
Follow through!
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“Clients and patients will not stop needing help and support. Disasters will continue to arise. Children will get
sick; trauma will occur. Helping professionals need to continue to explore ways to remain healthy while doing this
deeply challenging and rewarding work.” (Mathieu, 2012)
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VICARIOUS RESILIENCE
Involves the process of learning about overcoming adversity from the trauma survivor and the resulting positive transformation and empowerment through their empathy and interaction.
(Hernandez, Gangsei, and Engstrom, 2007) 33
1
Developing Self-
Awareness
2
Maintaining Hope
3
Practicing Healthy Coping
4
Creating Strong
Relationships
5
Remembering the
Big Picture
Vicarious Trauma Toolkit34
IMPACT OF VICARIOUS RESILIENCE
Greater perspective and appreciation of own circumstancesMore optimistic, motivated,
efficacious, and reenergized Increased sense of hope,
understanding, and belief in the possibility of recovery from trauma and other serious challenges Profound sense of commitment to,
and finding meaning from the work
(Hernandez, et al, 2007; Engstrom, et al, 2008)35
Compassion Satisfaction Pleasure derived from
work Pride in the sense of
purpose and contribution of work
Vicarious TransformationOngoing, intentional
process Brings deepened sense
of connection with others Increases gratitude,
sense of meaning and hope
Vicarious Trauma Toolkit36
Knowing the risks of this work, what keeps you in it?When you experience the
harms of this work, what will you do?What is ONE practice you
will implement in order to manage the effects of this work?What is the MOST
important thing you want to remember from today?
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American Counseling Association. “Vicarious Trauma” Fact Sheet #9. https://www.counseling.org/docs/trauma-disaster/fact-sheet-9---vicarious-trauma.pdf Bell, Holly, Shanti Kulkarni, and Lisa Dalton. 2003. “Organizational
Prevention of Vicarious Trauma.” Families in Society: The Journal of Contemporary Social Services 84(4): 463–470. doi:10.1606/1044-3894.131. Berger, William, Evandro Coutinho, Ivan Figueira, Carla Marques-
Portella, Mariana Pires Luz, Thomas C. Neylan, Charles R. Marmar, and Mauro Vitor Mendlowicz. 2011. “Rescuers at Risk: A Systematic Review and Meta-Regression Analysis of the Worldwide Current Prevalence and Correlates of PTSD in Rescue Workers.” Social Psychiatry and Psychiatric Epidemiology 47(6): 1001–1011. doi:10.1007/s00127-011-0408-2.
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Stress Among Domestic Violence Advocates: Workplace Risk and Protective Factors.” Violence Against Women 15(11): 1358–1379. doi:10.1177/1077801209347469. Trauma Informed Lens Podcast, Episode 77: Stress, burnout, and
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provided courtesy of https://pixabay.com/
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