NASW-OK 37NASW-OK 37thth Annual Annual State ConferenceState Conference

““Self-Care in Its Duality: Personal Self-Care in Its Duality: Personal & Organizational”& Organizational”

Lanny EndicottLanny EndicottOffice: 918-495-6543Office: 918-495-6543Cell: 918-830-1523Cell: 918-830-1523

lendicott@oru.eduhttp://drlannyendicott.com.tripod.com

lendicott@oru.eduhttp://drlannyendicott.com.tripod.com

AgendaAgenda

Discuss: Compassion Satisfaction, Discuss: Compassion Satisfaction, Compassion Fatigue, Secondary Traumatic Compassion Fatigue, Secondary Traumatic Stress, BurnoutStress, Burnout

Apply: Self assessment (ProQOL5), Self-care Apply: Self assessment (ProQOL5), Self-care plan, Support Group, Organizational Self-Careplan, Support Group, Organizational Self-Care

Deep BreathingDeep Breathing

Life is in the breathLife is in the breathAPPS:APPS:

PTSD CoachPTSD CoachPE CoachPE Coach

Breathe2RelaxBreathe2RelaxTactical BreatherTactical BreatherT2MoodTrackerT2MoodTracker

Sound SleepSound Sleep

Self-CareSelf-CareSelf-care is “very” important Self-care is “very” important

Why?Why?

Professional Self-Care: Professional Self-Care: Social WorkSocial Work

Self-care is critical to the survival andSelf-care is critical to the survival and growth of the social work profession –growth of the social work profession –

for the health of every social workerfor the health of every social worker

NASW Code: 4.05 ImpairmentNASW Code: 4.05 Impairment

a.a. Personal problems can disrupt your Personal problems can disrupt your judgment and ability, and can damage judgment and ability, and can damage the very people you trying to helpthe very people you trying to help

b.b. Social workers (helpers) should get Social workers (helpers) should get counseling, adjust workloads, or end counseling, adjust workloads, or end counseling with others to protect themcounseling with others to protect them

Compassion SatisfactionCompassion Satisfaction

• Positives of helpingPositives of helping– Pleasure and satisfaction from helping othersPleasure and satisfaction from helping others– Feeling good giving counseling and careFeeling good giving counseling and care– Encouraged by the organizationEncouraged by the organization– Enjoying work with othersEnjoying work with others– Having positive beliefs about yourselfHaving positive beliefs about yourself– Feeling spiritual fulfillment (“work is a calling”)Feeling spiritual fulfillment (“work is a calling”)

Compassion FatigueCompassion Fatigue

• Negative results from helpingNegative results from helping– Being overwhelmed giving counseling and careBeing overwhelmed giving counseling and care– Discouraged by the organizationDiscouraged by the organization– Poor work relations with othersPoor work relations with others– Negative beliefs about yourself (dreams, values)Negative beliefs about yourself (dreams, values)– Unfulfilled in your workUnfulfilled in your work

Secondary Traumatic StressSecondary Traumatic Stress

– Working with people who have traumaWorking with people who have trauma– Absorbing the trauma of othersAbsorbing the trauma of others– Personal exposure to traumaPersonal exposure to trauma– Retreating, avoidance, anxietyRetreating, avoidance, anxiety

BurnoutBurnout

• BurnoutBurnout– Feeling hopeless and helplessFeeling hopeless and helpless– Feeling worn outFeeling worn out– Burnout takes timeBurnout takes time– Similar to Secondary Traumatic Stress but takes Similar to Secondary Traumatic Stress but takes

longerlonger

BurnoutBurnout

DepersonalizationDepersonalization

I’ve lost my wayI’ve lost my wayI’ve lost meaning and purposeI’ve lost meaning and purpose

I’ve lost myselfI’ve lost myselfI’ve lost my soulI’ve lost my soul

DisillusionmentDisillusionment Fatigue or frustration caused by Fatigue or frustration caused by

devotion to a cause, way of life, or devotion to a cause, way of life, or relationship that failed to produce relationship that failed to produce the the expected rewardexpected reward

• Fatigue Fatigue • Frequent illnessFrequent illness• Sleep problemsSleep problems• Disillusionment with workDisillusionment with work

• Cynicism toward organization or Cynicism toward organization or clients clients • Helplessness/hopelessnessHelplessness/hopelessness• Powerless to change eventsPowerless to change events• Anger toward the organization or Anger toward the organization or

“clientele”“clientele”

• Depression and isolationDepression and isolation• Staying away from co-workersStaying away from co-workers• Being absentBeing absent• Being harsh with other workersBeing harsh with other workers• Reduced commitment to workReduced commitment to work• Consumption of chemicalsConsumption of chemicals

Burnout: A Gradual ProcessBurnout: A Gradual Process

• Unaware it is happeningUnaware it is happening• Work harder – accomplishing lessWork harder – accomplishing less• Exhausted, disillusioned, and isolatedExhausted, disillusioned, and isolated

• Results to the organization:–Low morale–Absenteeism–High turnover

Three Categories of SymptomsThree Categories of Symptoms“Is it helper PTSD?”“Is it helper PTSD?”

1.1. Intrusive thoughts, images, sensationsIntrusive thoughts, images, sensations2.2. Avoidance of people, places, things Avoidance of people, places, things

and experiences which elicit memories and experiences which elicit memories of the traumatic experienceof the traumatic experience

3.3. Negative arousal in terms of hyper- Negative arousal in terms of hyper- vigilance, sleep disturbances, vigilance, sleep disturbances, irritability and anxietyirritability and anxiety

Emotional IndicatorsEmotional IndicatorsAngerAnger

SadnessSadnessProlonged griefProlonged grief

AnxietyAnxietyDepressionDepression

Emotional IndicatorsEmotional IndicatorsAngerAnger

SadnessSadnessProlonged griefProlonged grief

AnxietyAnxietyDepressionDepression

Physical IndicatorsPhysical IndicatorsHeadachesHeadaches

Stomach achesStomach achesLethargyLethargy

Sleep problemsSleep problems

Physical IndicatorsPhysical IndicatorsHeadachesHeadaches

Stomach achesStomach achesLethargyLethargy

Sleep problemsSleep problems

Personal IndicatorsPersonal IndicatorsSelf-isolationSelf-isolation

CynicismCynicismMood swingsMood swings

Irritability with spouse/familyIrritability with spouse/family

Personal IndicatorsPersonal IndicatorsSelf-isolationSelf-isolation

CynicismCynicismMood swingsMood swings

Irritability with spouse/familyIrritability with spouse/family

Work IndicatorsWork IndicatorsAvoids certain clientsAvoids certain clientsMissed appointmentsMissed appointments

TardinessTardinessLack of motivationLack of motivation

Work IndicatorsWork IndicatorsAvoids certain clientsAvoids certain clientsMissed appointmentsMissed appointments

TardinessTardinessLack of motivationLack of motivation

A Key risk: Working with Traumatized A Key risk: Working with Traumatized ChildrenChildren

• EmpathyEmpathy• Experiencing children with traumaExperiencing children with trauma• Not enough time to recoverNot enough time to recover• Unresolved personal traumaUnresolved personal trauma• Poor support from the organizationPoor support from the organization

Spiritual Compassion Spiritual Compassion - Fatigue- Fatigue

• Having pityHaving pity• Having love and mercyHaving love and mercy• Being torn of heartBeing torn of heart• Having deep feelingsHaving deep feelings

• Losing heartLosing heart• Becoming faint and wearyBecoming faint and weary

Stress develops when you perceive Stress develops when you perceive that that demandsdemands exceed your personal exceed your personal and social and social resourcesresources

Stress develops when you perceive Stress develops when you perceive that that demandsdemands exceed your personal exceed your personal and social and social resourcesresources

Demands of:Demands of:• FamilyFamily• Work Work • Sickness/health problemsSickness/health problems• FriendsFriends• Self-expectationsSelf-expectations• Day-to-day conflictsDay-to-day conflicts• TransportationTransportation• Financial problemsFinancial problems• Environment (noise, Environment (noise,

crime)crime)

Demands of:Demands of:• FamilyFamily• Work Work • Sickness/health problemsSickness/health problems• FriendsFriends• Self-expectationsSelf-expectations• Day-to-day conflictsDay-to-day conflicts• TransportationTransportation• Financial problemsFinancial problems• Environment (noise, Environment (noise,

crime)crime)

Resources of:Resources of:• Good healthGood health• Positive self-thoughtsPositive self-thoughts• Social supportSocial support• Positive past experiencesPositive past experiences• Coping skillsCoping skills• Stress management skillsStress management skills• Healthy diet & exerciseHealthy diet & exercise• Spiritual discipline Spiritual discipline • Balanced lifeBalanced life• Positive work relationshipsPositive work relationships

Resources of:Resources of:• Good healthGood health• Positive self-thoughtsPositive self-thoughts• Social supportSocial support• Positive past experiencesPositive past experiences• Coping skillsCoping skills• Stress management skillsStress management skills• Healthy diet & exerciseHealthy diet & exercise• Spiritual discipline Spiritual discipline • Balanced lifeBalanced life• Positive work relationshipsPositive work relationships

DemandsDemands ResourcesResources

It rains—sometimes pours

Stress felt in neck, shoulders, and back

We carry this invisible barrel

Caring for YourselfCaring for YourselfPersonal LevelPersonal Level

Self Assessment1. Examine personal

traumatic experiences Assess triggers

2. Manage stress outside of work See “Healthy Activities”

3. Feedback Family, friends

co-workers

Self Assessment1. Examine personal

traumatic experiences Assess triggers

2. Manage stress outside of work See “Healthy Activities”

3. Feedback Family, friends

co-workers

Healthy Activities1. Sleep2. Exercise3. Diet4. Writing/journaling5. Spiritual disciplines6. Hobbies7. In-the-moment8. Deep breathing and

imagery

Healthy Activities1. Sleep2. Exercise3. Diet4. Writing/journaling5. Spiritual disciplines6. Hobbies7. In-the-moment8. Deep breathing and

imagery

Work LevelWork Level

1. At Work— Daily beginnings –

endings— Fatigue check

2. Professional— Support from others— Consulting— Hopefulness

1. At Work— Daily beginnings –

endings— Fatigue check

2. Professional— Support from others— Consulting— Hopefulness

3. System— Organization self-care

plan— Support groups— Social activities— Safety plan

3. System— Organization self-care

plan— Support groups— Social activities— Safety plan

What is your organization doing What is your organization doing for worker stress?for worker stress?

Embrace Corporate Care!Embrace Corporate Care!

http://www.sanctuaryweb.com/sanctuary-http://www.sanctuaryweb.com/sanctuary-model.phpmodel.phphttp://www.sanctuaryweb.com/sanctuary-http://www.sanctuaryweb.com/sanctuary-model.phpmodel.php

Hindrances to focusing on worker health

• Pressure from the “numbers”Pressure from the “numbers”• Lack of awareness regarding staff sick days, Lack of awareness regarding staff sick days,

low morale, turnover low morale, turnover

Some Ideas to Consider

• Have monthly staff meetings to talk about personal stress and well-being: – Have someone in the agency assigned to process

small group meetings to address worker stress– Bring in an external consultant to conduct small

group meetings– Plan small group lunches and activities

(massages, yoga, etc.)

To Make Small Groups WorkTo Make Small Groups Work• Must be atmosphere of safety• Being civil with one another• Being respectful

ORU Social Work Program Core Competencies and ORU Social Work Program Core Competencies and Associated BehaviorsAssociated Behaviors

2012-20132012-2013 1—Identify as a professional social worker and conduct oneself

accordingly. (Associated behaviors: practice advocacy and self-reflection;

attend to professional roles and boundaries; engage professional demeanor; pursue life-long learning; seek supervision and consultation, practice self-care)

2—Apply social work ethical principles to guide professional practice. (Associated behaviors: manage personal values; apply NASW Code

of Ethics; appreciate ambiguity; engage ethical reasoning to make decisions)

1—Identify as a professional social worker and conduct oneself

accordingly. (Associated behaviors: practice advocacy and self-reflection;

attend to professional roles and boundaries; engage professional demeanor; pursue life-long learning; seek supervision and consultation, practice self-care)

2—Apply social work ethical principles to guide professional practice. (Associated behaviors: manage personal values; apply NASW Code

of Ethics; appreciate ambiguity; engage ethical reasoning to make decisions)

Assessment Instruments & ResourcesAssessment Instruments & ResourcesIdaho State UniversityIdaho State University

ProQOL5 instrument from Idaho State ProQOL5 instrument from Idaho State University:University: http://www.isu.edu/~bhstamm/http://www.isu.edu/~bhstamm/

ProQOL5 instrument from Idaho State ProQOL5 instrument from Idaho State University:University: http://www.isu.edu/~bhstamm/http://www.isu.edu/~bhstamm/

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Headington InstituteHeadington Institute

http://www.headington-institute.org/http://www.headington-institute.org/Default.aspx?tabid=1379Default.aspx?tabid=1379

Authentic Happiness WebsiteAuthentic Happiness Website

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National Child Traumatic Stress National Child Traumatic Stress NetworkNetwork

• http://www.nctsn.org/products/secondary-traumatic-stress-fact-sheet-child-serving-professionals%20

Lanny EndicottLanny EndicottOffice: 918-495-6543Office: 918-495-6543Cell: 918-830-1523Cell: 918-830-1523