Sunday

Recovery Process for Compassion Fatigue

Secondary traumatic stress reactions should be considered as inevitable for counselors who work with clients with traumatic stress.

Supervisors working in areas specializing in crisis or trauma work need to monitor and evaluate the levels of stress and trauma experienced by their staff on a regular basis.

Effective supervision plays a valuable role in addressing symptoms associated with compassion fatigue, as therapists may be reluctant to discuss their symptoms of compassion fatigue with co-workers or supervisors due to fears of job loss.

Practice healthy coping strategies by creating a personal wellness plan that embraces the cognitive, emotional, behavioral, spiritual, interpersonal and physical dimensions of wellness.

Choose Wellness!

Saturday

Compassion Fatigue

Compassion Fatigue is "...the natural consequent behaviors and emotions resulting from knowledge about a traumatizing event experienced by a significant other or from helping or wanting to help a traumatized person". (Dr. Charles Figley, 1995)

Compassion Fatigue, also referred to as compassion stress or secondary traumatic stress, is a job hazard primarily associated with clinical settings and crisis events. Crisis workers who are the first responders in crisis situations or mental health practitioners who work with traumatized clients on a regular basis may experience negative consequences to their health and relationships and may be a risk for substance abuse or professional impairment.


Symptoms of Compassion Fatigue include:

  • Psychological Distress - Addictive or compulsive behaviors, distressing emotions, nightmares, somatic complaints, or impairment in day-to-day functioning.
  • Cognitive Shifts - Changes in beliefs assumptions or expectations; feeling guilty about good things in your life or feeling threatened or manipulated by your clients.
  • Relational Disturbances - Changes in relationships, professionally or personally, where the counselor distances himself from others or takes excessive control or responsibility of clients or loved ones.

Causes of Compassion Fatigue:

  • Direct client contact and prolonged exposure to clients who have experienced trauma. Fatigue response based on client-therapist relationship.

Higher risk of Compassion Fatigue for counselors who:
  • are highly empathetic
  • have had a personal experience with a traumatic event
  • have unresolved traumatic conflicts
  • work with traumatized children
  • work with clients who have a history of psychological trauma, such as with military combat
  • work with clients who have experienced trauma as a result of criminal victimization, natural disasters or social violence
Choose Wellness!

Work Environment Stress

Stressors for mental health professionals in the work environment include:

Time Pressures


Negative Colleagues and/or Supervisors


Organizational Politics


Excessive Paperwork


Type of Clinical Setting
  • private practice
  • Group independent practice
  • community mental health agencies
  • residential treatment facilities
  • hospitals
Higher levels of stress have been reported in public agency settings rather than solo or group independent practice.

Higher levels of stress have also been reported due to:

Role Conflicts

  • In private practice, this could mean more time being spent on billing or advertising than conducting therapy.
  • In an agency setting, problems may occur with supervisors, agency policies, paperwork or being assigned tasks unrelated to clinical work.

Primary Causes of Job Stress

The term job stress refers to the stress derived from one's career, work or place of employment.

Job stressors are the demands made in the environment, both internal and external, that upset balance and affect a worker physically or psychologically.

A worker's characteristics and the work environment have been identified as the primary causes of job-related stress.

Worker's Characteristics (internal)
  1. Personality Traits
  2. Coping Style
  • Emotion-focused coping involves trying to reduce stress-related symptoms emotionally; better for short-term or unchangeable stressors.
  • Problem-focused coping involves trying to eliminate or change work-related stressors; beneficial for long-term social or environmental factors.

Work Environment (external)

Examples include:
  • Excessive workload demands
  • interpersonal relationships
  • work role conflicts
  • environmental conditions
  • different styles of management personnel
  • the design of work-related tasks

American Psychological Association Research Study (2007)

Individuals working in education and health service industries experienced higher levels of stress than those working in other professions, with four out of ten people experiencing extreme levels of stress.

Thursday

Stress Reduction Techniques

Stress reduction techniques recommended by numerous stress management training programs include:

meditation

yoga

visual imagery

muscular relaxation

aerobic exercise

listening to music

Some of these stress reduction techniques may be beneficial for your stress management. Please remember, some techniques may be effective for you but not for others.  

Begin to include at least one of these techniques into your regular routine.  You could bring an iPod to work and take a 15 minute break by relaxing in your chair, closing your eyes and listening to music.  (Stay off the computer during your break!!)  If you are able, you could take a 15 minute walk outside on your break, incorporating 2 stress reduction techniques - aerobic exercise and listening to music. 

On weekends, give yourself time to relax.  If your schedule is so full that you don't have a minute to breath, then you will need to add scheduled breaks to your calendar...and make sure you keep those "appointments" because they may end up being the most IMPORTANT appointments you'll ever have.
Choose Wellness!

Tuesday

Stressors for Counseling Students

Graduate school can be a wonderful experience; however, it can also become a stressful experience for students juggling academics, jobs, internships, families, finances, health issues, etc...!  Categories of student stress include competition, organization of time, administrative concerns,  instruction, finances and adjusting to a new social environment.  Grades, exams and studying can be the most critical stressors.  In addition to academic stress, graduate counseling students must also devote time and energy to complete practicum and/or internships necessary for graduation.   With all these stressors, self-care can take a back seat.  Counseling graduate students spend years learning how to help others in the therapeutic process but can neglect their own needs.  Students can become proactive in preventing stress-related and lifestyle-related chronic disease by becoming their #1 Client in utilizing self-care strategies to develop a holistic and healthier lifestyle.  Will you choose to become your #1 Client??
Choose Wellness! 

Wednesday

Healthy Coping Strategies

As clinicians, we may advise our clients to strive for balance...moderation...practice self-care. Good advice; however, many clinicians may not always follow their own advice!  By changing certain aspects of our lifestyles and daily habits, we may help decrease our vulnerability to the stressors that lead to distress in our lives.  

Some healthy coping strategies that you may wish to introduce into your life to help minimize the negative effects of stress include:

1) Anticipate your needs for the day and plan ahead. (cognitive)
2) Keep your sense of humor in tense situations. (emotional)
3) Participate in a new, fun activity during the work week.  Go bowling! (behavioral)
4) Take time for daily meditation. (spiritual)
5) Visit with a friend and don't discuss work! (interpersonal)
6) Strive for at least 7 - 8 hours of sleep a night. (physical)

Choose Wellness!

Monday

Reducing job stress

An excellent book by Jon Kabat-Zinn, PhD, Full Catastrophe Living:  Using the wisdom of your body and mind to face stress, pain, and illness, offers some suggestions for reducing work stress by using the practice of "awareness".  Instead of going through your day in a semi-conscious state or as we like to say, "going through the motions", begin the practice of awareness by being fully present in the moment.  To reduce job stress, let's start at the beginning of the day...when you first wake up.  Take a moment while lying in bed to re-affirm that today you are choosing to go to work.  Briefly review what your goals are for the day, the clients you have scheduled for the day...and understand that everything may not happen the way you would plan.  Be aware as you get dressed for your day of the way you wish to present yourself...how you will interact with others?  Focus on your breathe and body...are you frowning or smiling?  Try putting a smile on your face and experience the way it affects your body and how others react to you.  During the day, monitor your body...what types of sensations do you have?  Any tension or pain?  How are you communicating with others?  What are the times of the day that seem more problematic for you?   Take a break to relax...go for a short walk outdoors if possible.  What?  No breaks??  Then it's time to work a few breaks into your schedule...make breaks a routine part of your schedule!  How many clients do you schedule back-to-back-to back?  How effective are you when you don't allow some time for yourself throughout the day?  When it is time to leave the office for the day, be aware that your work day is over...begin to make the transition to your personal life and then review the activities and people that will be part of your private time.  Make sure you change out of your work clothes at home to move consciously into your non-work life.  What?  No personal life? No activities, hobbies, relationships??  Remember....balance!  Choose Wellness!

Sunday

Warning signs of job stress

Some of the early warning signs of job stress are reported as headaches, agitation in the workplace, upset stomach, difficulties in memory or concentration and sleep disturbances.  Acute stressors occur over short periods of time and come and go.  Chronic stressors occur over extended periods of time and this is the type of stress that creates long-term health problems, both physical and psychological.  The way a person reacts to stress is called a stress response.  A response which resolves the immediate stressor is referred to an adaptive response.  A response which does not alleviate the problem and could potentially cause health concerns, including death, is called a maladaptive response.  Signs of job stress for clinicians, including those mentioned above, include distancing themselves from clients, isolating from peers, showing up for appointments late, falling behind in paperwork, avoiding taking on additional job responsibilities or giving away their job tasks to co-workers. Clinicians may also experience problems in their personal and family lives.
Choose Wellness!

Monday

Stressors for Clinicians

Sources of stress for psychotherapists include client-induced stress, self-induced stress, work environment stress and event-related stress (Kottler, 2003).  Acute stressors last only a short period of time and can come and go.  Chronic stressors extend over long periods of time and can result in psychological disorders, cardiovascular disease or musculoskeletal disorders.  Six high-level sources of client-induced stress for psychotherapists are suicidal ideation, aggressive behaviors, impulsive behaviors, apathy, depression and premature termination of therapy (Faber, 1983).  Examples of self-induced stress include physical exhaustion, self-doubt and an unhealthy lifestyle (Kottler, 2003).  Work environment stress can result from time pressures and practice settings.  Per research conducted by Rupert and Kent (2007), higher levels of stress were reported in public agency settings rather than solo or group independent practice.  Event-related stressors can include malpractice claims (Welfel, 2006) or major life transitions, like divorce (Kottler, 2003). 
Choose Wellness!