Self Careand

Self-Care Policy in the Workplace

ByRoxy Falsetto

"In traditional Native American teaching, it is said that each time you heal someone you give away a piece of yourself until, at some point, you will require healing" (Bush, 2009, p.26).

What is Self Care?Self-care can be a broad topic because it has many meanings based on the context in which it is being used.

• To the layperson, self-care may be defined as being independently active to initiate and maintain personal well-being throughout life.

• On a global scale, the World Health Organization defined self-care as, “activities individuals, families, and communities undertake with the intention of enhancing health, preventing disease, limiting illness and restoring health.”

(Lucock, Gillard, Adams, Simons, White, & Edwards, 2011; Profitt, 2008).

• In the context of the helping professions, self-care is also an ethical obligation.

• Something the helping professional must personally and professionally take

seriously.

• Especially practitioners with a pre-existing disorders such as anxiety, mood, or

personal trauma history because:

• They may be at greater risk of experiencing trauma related conditions

• In maintaining their self-care, they gain and maintain positive energy

and regenerate their empathy

(Lucock, Gillard, Adams, Simons, White, & Edwards, 2011; Profitt, 2008).

Trauma-Informed Self-Care (TISC).TISC is what most if not all helping professionals follow. TISC calls for the helping

professional to be aware of their emotional experiences when treating traumatized clients, and

to plan active coping strategies, such as:

• set healthy boundaries and limits with clients• engage in supervision• attend continuing education on trauma and its effects on the professional• balance caseloads• practice stress management techniques• pursue therapy that is centered around the issues that trigger you at work• create a plan that balances work and life• restore physical, mental, and spiritual health (Moore et al., 2011; Profitt, 2008). (Salloum et al., 2015).

Due to the high turnover rates in the helping professions more attention is being put toward combating burnout, compassion fatigue, and vicarious trauma; by incorporating self-care practices into their daily lives.

Burnout “Professional burnout can be defined as a state of physical, emotional, psychological, and spiritual exhaustion resulting from chronic exposure to (or practice with) populations that are vulnerable or suffering.”• Human service work is said to be the single largest risk factor for developing professional

burnout.• This risk factor could be contributed to the practitioner’s ability to repress uncomfortable

emotions while at the same time having to use empathy.• Not necessarily the stressor that causes the burnout, but the practitioner's response to the

stressful situation.• Practitioners who tend to be more idealistic, highly motivated, and highly empathic tend to

be the first to experience burnout.(Bush, 2009”(Newell & MacNeil, 2010, p.58). ).

Three Distinct Domains to Burnout:

• Emotional exhaustion

• Depersonalization

• A reduced sense of personal accomplishment

(Adams et al., 2008; 2007; Bush, 2009; Davies et al., 2008; Newell & MacNeil, 2010).

Compassion FatigueUnchecked burnout can reach a new level in the form of compassion fatigue (CF). Compassion fatigue is defined as a syndrome that is a combination of secondary traumatic stress ( secondhand post-traumatic stress disorder from listening to and internalizing firsthand trauma) and professional burnout, with specific symptoms. The symptoms associated with CF are both emotional and physical and result from a chronic use of empathy. CF:• Is Cumulative• Is Pervasive• Can happen suddenly without warning.(Adams et al., 2008; 2007; Bush, 2009; Davies et al., 2008; Newell & MacNeil, 2010; Portnoy, 2011; Salloum et al., 2015).

These symptoms may sound similar to those associated with burnout. However in addition to burnout symptoms, practitioners presenting with CF tend to experience:

• a reduced capacity for empathy• a reduced sense of career reward• a loss of meaning and hope• feelings of anxiety• difficulty concentrating• Irritability• sleep deprivation• deep emotional numbing• flashbacks of their client’s traumatic event • past trauma memories

(Adams et al., 2008; 2007; Bush, 2009; Davies et al., 2008; Newell & MacNeil, 2010; Portnoy, 2011; Salloum et al., 2015).

CF can have long-term effects that can lead to the practitioner escaping from life by using:

• Food• Drugs• Alcohol• Other forms of addiction.

Through self-care and balanced empathy, the practitioner will find a healthy balance between emotional over involvement with patients and emotional distance.

(Adams et al., 2008; 2007; Bush, 2009; Davies et al., 2008; Newell & MacNeil, 2010; Portnoy, 2011; Salloum et al., 2015).

Vicarious TraumaBurnout and CF have thresholds and going beyond each one can be detrimental to the practitioner's entire cognitive framework. It is believed that once cognitive schemas are set in place they are to remain unchanged. However unchecked burnout and CF can lead to the most destructive of all trauma-related stress conditions, vicarious trauma. “Vicarious traumatization refers to a ‘process of [cognitive] change resulting from [chronic] empathic engagement with trauma survivors’”. This immediate onset in “cognitive shifts” can change a practitioner's:• sense of self• worldview• sense of safety• ability to trust• sense of control• spiritual beliefs(Bush, 2009; Newell & MacNeil, 2010; Profitt, 2008; Salloum et al., 2015).

The practitioner dealing with vicarious trauma may find it hard to relate to others, due to the fundamental aspects of their life transforming. Hence, their identity changes and their inability to regulate intense feelings may cause loved ones to avoid them, and they may lose credibility with their colleagues. This chain of events may cause the practitioner to distance himself/herself altogether from society. Once a practitioner reaches this point of vicarious trauma, it is imperative that they seek psychological intervention.

(Bush, 2009; Newell & MacNeil, 2010; Profitt, 2008; Salloum et al., 2015).

Self-Care Policy in the WorkplaceResearch indicates organizations that helping professionals work for may contribute to trauma-related stress conditions. This realization may have to do with:

• excessively high caseloads• lack of control or influence over agency policies and procedures• unfairness in organization structure and discipline• low peer, and supervisory support• poor agency and on-the-job training

(Bush, 2009; Newell, & MacNeil)

There are noticeable behavior indications that take place within a facility that does not practice TISC. The following behaviors should be warning signs of burnout, CF, and vicarious trauma:

• not showing up for work• habitual tardiness• chronic fatigue• poor client interaction• incompletion of organizational duties.

(Bush, 2009; Davies et al., 2008; Newell & MacNeil, 2010; Profitt, 2008; Salloum et al., 2015)

• Organizations that specialize in caring for the psychological health of others, and implement TISC policy for their helping professionals, may eliminate burnout, compassion fatigue, and vicarious trauma.

• The overall energy and well-being of those working in the facility may improve.

• Research shows that facilities who have a TISC policy in place report that their staff shows higher levels of compassion satisfaction, retention, and engagement.

• Establishing a TISC policy will have a positive effect on all stakeholder within the facility.

(Bush, 2009; Davies et al., 2008; Newell & MacNeil, 2010; Profitt, 2008; Salloum et al., 2015)

An organization with a strong TISC policy will include self-care within its mission statement.

A strong TISC policy will incorporate:

• training on burnout, CF, and vicarious trauma for all new staff members• realistic caseloads that are established and agreed upon• burnout, CF, and vicarious trauma survey instruments every six months to assess for

organizational and individual risks• An organization website to give clients an outlet to anonymously express their appreciation

for the services they received • employee written goal assignments that are focused on goals for work and life• These goals should be revisited and revised every six months

• employee assistance programs• to assist each other with excess clerical work and possibly taking on a client when a

colleague is unable• To add emotional support

(Adams et al., 2008; 2007; Bush, 2009; Davies et al., 2008; Newell & MacNeil, 2010; Salloum et al., 2015).

Thank You!

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