Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction...

45
Compassion Fatigue Compassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FT LCSW, FAMI, FT

Transcript of Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction...

Page 1: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Compassion FatigueCompassion FatigueCompassion Satisfaction

Presenter: Barbe Creagh, PhD,LCSW FAMI FTLCSW, FAMI, FT

Page 2: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Stressors in Healthcare

Reduced administrative overhead Increased paperwork Increased paperwork Increased workloads

l f Elimination of support systems Short-term savings, but long-term costs Impact on staff morale Quality of care Quality of care

Page 3: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Compassion Fatigue: The Cost of p gCaring

Compassion Fatigue (FT) Compassion Fatigue (FT)

d ( ) Secondary Traumatic Stress (STS)

Vicarious Trauma (VT)

Page 4: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Common Factors

Work-related

Secondary exposure to extremely stressful events

Symptoms-rapid onset and associated with Sy pto s ap d o set a d assoc ated ta particular event

Page 5: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Compassion Fatigue

“a natural consequence of working with people who have experienced extremelypeople who have experienced extremely stressful events”

develops as result of “provider’s develops as result of provider s exposure to there patients’ experiences combined with empathy for therecombined with empathy for there patients.”

(Figley 1995)(Figley, 1995).

Page 6: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Vicarious traumatization

Effect that working with individuals who have experienced trauma have on staff.have experienced trauma have on staff.

“the transformation or change in a “the transformation or change in a helper’s inner experience as a result of responsibility for and empathicresponsibility for and empathic engagement with traumatized clients.”

Page 7: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Signs and symptoms of the cost g y pof caring

Physical Emotional PsychologicalIrritability Grief Changes in life y g

viewSleep Rage Decreased disturbance feeling of

personal safetyAppetite change Anger Loss of

professional identityidentity

Page 8: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Signs and Symptoms

Decreased energy

Powerlessness Increased interpersonal conflicts

Anxiety Numbness Increasing cynicism

Breathing d ff l

Fear Isolation from hdifficulties others

Rapid h tb t

Helplessness Low motivationheartbeat

Page 9: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Signs and Symptoms cont’d

Somatic complaints

Overly sensitive

Decreased ability to cope with stress

Nightmares Depression Negativity

Hypervigilance Sadness Loss of Faith

Impaired immune

Emotional roller coaster

Apathy

system

Page 10: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Organizational Costs

Absenteeism

Morale

Quality of Care

Page 11: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Compassion Fatigue Symptoms

Intrusive Symptoms Thoughts and images associated with client’s Thoughts and images associated with client s

traumatic experiences Obsessive and compulsive desire to helpObsessive and compulsive desire to help

certain clients Client/work issues encroaching upon personal / g p p

time Inability to “let go” of work-related mattersy g

Page 12: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Intrusive Symptoms cont’d

Perception of survivors as fragile and needing the assistance of caregiver (“savior”)

Thoughts and feelings of inadequacy as a caregiver

Sense of entitlement or special-ness Perception of the world in terms of victims

and perpetrators Personal activities interrupted by work-related

issues

Page 13: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Avoidance Symptoms

Silencing Response Loss of enjoyment in activities/cessation of j y /

self care activities Loss of energygy Loss of sense of competence/potency Isolationso at o Secretive self-medication (alcohol, drugs,

work, sex, food, spending, etc.), , , p g, ) Relational dysfunction

Page 14: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Arousal Symptoms Increased anxiety Impulsivity/reactivity

I d ti f d d/th t (i Increased perception of demand/threat (in both job and environment)

Increased frustration/anger Increased frustration/anger Sleep disturbance Difficulty concentrating Change in weight/appetite Somatic symptoms (Figley, 1995)

Page 15: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Burnout

Feelings of hopelessness Difficulties in dealing with work Difficulties in dealing with work Difficulty doing your job effectively

“ l d ” “melting down” Physically emotionally, mentally

Page 16: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Four Phases of Stress leading to gburnout

1. Warning signs. a Emotional in naturea. Emotional in natureb. Feelings of vague anxiety,c. Fatigue, d. Boredom, e. and disinterest with the job

Page 17: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Phases of stress cont’d2. Mild Symptoms

a. Escalation of early warning signsb. Reduced emotional controlc. Sleep disturbancesd. Muscle achese. Loss of energy and focusf. Nauseag. Social withdrawalh E i f ih. Excessive fatigue

Page 18: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Phases of stress cont’d

2. Entrenched symptoms

a. prolonged stress reaction

b. Career, personal, family issues

Page 19: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Phases of stress cont’d

Symptoms include Skin rashes

Loss of appetite Muscle weakness

Increased alcohol intake

High blood pressure Loss of sexual

Severe migraines Excessive irritability

Loss of sexual appetite

Complete social cess e tab ty Irrational feats Rigidity in thought

Co p ete soc awithdrawal

Missed work Rigidity in thought

Page 20: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Phases of stress cont’d4. Debilitating symptoms Destructive phase Coronary disease

Suicidal feelings Thought disorder

Diabetes Heart attack

Uncontrolled crying Very ill person who

ff Asthma Complete agitation

suffers Emotionally Mentally

Constant tension hostility

Mentally Physically(Schneider, M, 2007)

Page 21: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Preventing Burnout Recognize the early

stages of burnout Strengthen relationships

with family and friends. Network of peers to

call. Annual health checks

Maintain balance between work and personal life. Annual health checks

and screenings. Exercise and rest

p Evaluate your workload (Schneider,M., 2007)

Nonrelated work activities

Page 22: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Preventing CF and promoting resiliency Become informed Join Stress study

Bring your life into balance.

group Begin exercise

program today

Develop artistic or sporting disciplineBe kind to yourselfprogram today.

Teach others how to support you.

Be kind to yourself Seek short-term

treatmentsupport you. Develop your

spirituality

treatment (Gentry/Baranowsky,

1997)

Page 23: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Negative Coping Blame others Look for a new job, buy a new car, get a

divorce or have an affair Habit of complaining with your colleagues

Hi l Hire a lawyer Work harder and longer

S lf di t Self-medicate Neglect you own needs and interests. (Pfifferling & Gilley 2000) (Pfifferling & Gilley, 2000)

Page 24: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Positive Coping

Find someone to talk to Understand that the pain you feel is normalp y Start exercising and eating properly Get enough sleep Get enough sleep Take some time off Develop interests outside of work Develop interests outside of work Identify what’s important to you (Pfifferling & Gilley, 2000)(Pfifferling & Gilley, 2000)

Page 25: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Compassion Satisfaction

The pleasure you derive from being able to do your work well.

Pleasure in helping others through your work Feel positively re your colleaguesp y y g Feel positively re your ability to contribute to

the work setter and good of society.(Stamm & Stamm, 1997)

Page 26: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Compassion Satisfaction

Caring is in balance.

Self-care plan in place

Self-care plan strong enough to balance the stress of the emotional impact and suffering.

Page 27: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

HeartMath™ Tools

Heart Lock-In

BreatheActivate a feeling of appreciation Activate a feeling of appreciation

Send feelings of care

www.HeartMath.org

Page 28: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Positive Coping

Develop your own self-care plan Spend plenty of quiet time alone Spend plenty of quiet time alone

Recharge your batteries daily Recharge your batteries daily

Hold one focused connected and Hold one focused, connected and meaningful conversation each day.

Page 29: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

The Quick Coherence® Technique for Adultsq

Create a coherent state in about a minute with the simple, but powerful steps of the Quick Coherence® Technique Using theQuick Coherence® Technique. Using the power of your heart to balance thoughts and emotions, you can achieve energy, mental clarity and feel better fast anywhere Useclarity and feel better fast anywhere. Use Quick Coherence especially when you begin feeling a draining emotion such as frustration, irritation anxiety or anger Find a feeling ofirritation, anxiety or anger. Find a feeling of ease and inner harmony that’s reflected in more balanced heart rhythms, facilitating b i f ti d t hi hbrain function and more access to higher intelligence.

Page 30: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT
Page 31: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT
Page 32: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Quick Coherence® will help you find a feeling of ease and inner harmony that will be reflected in your heart rhythms. The heart is a primary generator of rhythm in your body, influencing brain processes that control your nervousbrain processes that control your nervous system, cognitive function and emotion. More coherent heart rhythms facilitate brain function, ll i hi hallowing you more access to your higher

intelligence so you can improve your focus, creativity, intuition and higher-level decision-creativity, intuition and higher level decisionmaking. When you’re in heart-rhythm coherence, you perform at your best – what thl t ll b i i th Y f lathletes call being in the zone. You feel

confident, positive, focused and calm yet energized.energized.

Page 33: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT
Page 34: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT
Page 35: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT
Page 36: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT
Page 37: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT
Page 38: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

You can do the Quick Coherence® Technique anytime, anywhere and no one will know you’re doing it. In less than a minute, it creates positive changes in your heart rhythms, sending powerful signals to the brain that can improve how you’re feeling. Apply this one-minute technique first thing in the morning, before or

The Quick Coherence® Technique for AdultsCreate a coherent state in about a minute with the simple, but powerful steps of the Quick Coherence® Technique. Using the power of your heart to ba

The Quick Coherence® Technique helps you create a coherent state, offering access to your heart’s intelligence. It uses the power of your heart to balQuick Coherence® will help you find a feeling of ease and inner harmony that will be reflected in your heart rhythms. The heart is a primary generatStep 1: Heart Focus. Focus your attention on the area around your heart, the area in the center of your chest. If you prefer, the first couple of times yStep 2: Heart Breathing. Breathe deeply but normally and feel as if your breath is coming in and going out through your heart area. As you inhale, Step 3: Heart Feeling. As you maintain your heart focus and heart breathing, activate a positive feeling. Recall a positive feeling, a time when you fQuick Coherence® is especially useful when you start to feel a draining emotion such as frustration, irritation, anxiety or stress. Using Quick Cohere

p y g pp y q g g,during phone calls or meetings, in the middle of a difficult conversation, when you feel overwhelmed or pressed for time, or anytime you simply want to practice increasing your coherence. You can also use Quick Coherence whenever you need more coordination, speed and fluidity in your reactions.RecommendationsTransforming Stress: Childre, Rozman. This first in the HeartMath Transforming Series books contains a complete discussion of the Quick Coherence Technique – a simple, straightforward method you can easily learn for transforming stress by shifting your heart rhythms. This book is one of HeartMath’s most important works, relying on years of research into stress and emotional management and providing you with , y g y g p g yscientifically based and proven methods for transforming your stress and your life. Also available in e-booklet. emWave® PC / emWave® Mac Stress Relief System: The emWave PC/Mac allows you to watch your heart rhythms in real time and see how intentionally changing emotions affect them. With a patented, noninvasive y y g g p ,heart-rhythm monitor, the emWave PC/Mac is a software/hardware program that collects pulse data through a fingertip or ear sensor and translates the information from your heart rhythms into user-friendly graphics displayed on your computer monitor. You’ll discover which emotions you can activate to effectively manage stress and boost vitality. Among other features, the emWave PC/Mac package includes the Coherence y g p gCoach™, an entertaining software application that teaches the Quick Coherence Technique.

Page 39: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

IHM is dedicated to conducting research and providing programs for schools and familiesproviding programs for schools and familiesto facilitate heart-based living.

copyrights 2010, Institute of HeartMath

Page 40: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Compassion Fatigue: a call for growth

“That which is to give light must g gendure burning.” (Frankl, 1963, p. 129).129).

Page 41: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Promoting quality of care Leadership interventions

A i f CF B t Assessing for CF or Burnout

Education and skill building Education and skill building

Create a culture of caringC eate a cu tu e o ca g

(White, D., 2006)

Page 42: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Beech, P. The nurse is not for burning, Nursing Standard,v 21(20), January 2007, pp. 62-64.

Figley, C.F. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (pp. 1-20). New York: Brunner/Mazel PublishersPublishers.

Figley, C.F. (1995). Compassion fatigue as secondary traumaticstress disorder: An overview. In C.F. Figley (Ed.), g y ( ),Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (pp. 1-20). New York:Brunner/Mazel, Publishers.

Page 43: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Figley, C.R. (2001). Compassion Fatigue: An Introduction. Green Cross Foundation, Florida State University Traumatology Institute, pp 1-

5. http://www.greencross.org_Research/CompassionFatigue.asp retrieved June 20 2007retrieved June 20, 2007.

Gentry, Baranowsky & Dunning. Accelerated Recovery Program for Compassion Fatigue. Presented at the: Thirteenth Annual p gInternational Society for Traumatic Stress Studies Conference.

Queen Elizabeth Hotel. Montreal, QB, CAN, November 9, 1997.

HeartMath The Heart Lock-In www HeartMath org HeartMath. The Heart Lock-In. www.HeartMath.org

McHolm, F. , Rx for Compassion Fatigue. Journal of Christian Nursing. v.23 (4), Fall 2006, p 12-19.

Page 44: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Pfifferling, JH & Gilley, K. Overcoming Compassion Fatigue. Family Practice Management, April, 2000.

Rudolph, J.M., Stamm, Bh.H. & Stamm, H.E. (Nov, 1997). Compassion Fatigue: A Concern for Mental Health Policy, Providers & Administration Poster at the 13th AnnualProviders & Administration. Poster at the 13 Annual Meeting of the International Society for Traumatic Stress Studies, Montreal, PQ, CA.

Schneider, M.A. Extinguish Burnout. Nursing Management. v.38 (3), March, 2007, p. 44-48.

Page 45: Compassion Fatigue Barbe Creagh.ppt · Compassion FatigueCompassion Fatigue Compassion Satisfaction Presenter: Barbe Creagh, PhD, LCSW FAMI FTLCSW, FAMI, FT

Stamm, B.H. (Ed.) (1999). Secondary Traumatic Stress: Self-Care Issues for Clinicians, Researchers and Educators, 2nd Ed Lutherville MD: Sidran Press2 Ed. Lutherville, MD: Sidran Press.

White, D. The Hidden Costs of Caring: What Managers Need to Know Health Care Manager v 25 (4) October/DecemberKnow. Health Care Manager, v. 25 (4), October/December, 2006, pp341-347.